Total Shoulder Replacement Denver
What is a Total Shoulder Arthroplasty?
Total shoulder arthroplasty (TSA) is performed when the glenoid socket is damaged and needs to be replaced. The primary goal of the surgery is to alleviate the pain associated with arthritis but most patients also experience improved shoulder function and range of motion after their joint replacement.
There are several different styles of total shoulder replacement prostheses (implants) that vary in size, shape, composition, and fixation. Most shoulder replacement systems share a similar basic design consisting of an all-plastic glenoid (shoulder blade) component and a metal humerus (upper arm bone) component. The glenoid component is cemented in place initially and over time, the patient’s bone will grow around the plastic to enhance stability and long-term fixation of the component. The humeral component is composed of a metal ball that is attached to a metal stem, which is cemented or impacted (press-fit) into the top of the humerus bone. The metal ball articulates with the plastic glenoid component allowing smooth motion of the shoulder joint once again. The style of shoulder replacement that is used for any particular patient is dependent on the patient’s unique anatomy, medical history, and bone quality.
What can I Expect after Surgery?
Most shoulder replacement patients will spend one to two nights in the hospital to work on gentle range of motion with a physical therapist, activities of daily living (dressing, showering, etc) with an occupational therapist, and to find an adequate pain medication regimen. The majority of shoulder replacement patients go home after leaving the hospital but some require a short stay at a rehabilitation facility if they will not have enough support at home after discharge. Case managers evaluate each patient’s situation and will arrange any home care that may be necessary.
Most surgeons will have their patients wear a sling for at least the first few weeks after surgery. The incision is typically in the front of the shoulder and is usually around six to eight inches long. Based on the nature of joint replacement surgery, most patients experience a moderate amount of bruising and swelling of their surgical arm and occasionally the chest. Every patient has a different pain tolerance after surgery but almost everyone requires pain medication for at least the first few weeks postoperatively. The first follow-up appointment in the surgeon’s office is typically seven to ten days after the surgery.
What is the Rehabilitation after Shoulder Replacement Surgery?
A structured rehabilitation program is crucial for any total shoulder replacement surgery to be successful. Most shoulder surgeons have their preferred postoperative physical therapy regimen but each rehabilitation program is designed and adjusted based on the patient’s unique physical ability, surgery performed, and progress throughout the program. The rehabilitation programs for traditional, reverse, and partial total shoulder replacements typically follow the same general protocol with gentle range of motion beginning the day after surgery. More aggressive physical therapy is added several weeks after surgery and most patients will continue with therapy for three or more months postoperatively.
How Long Does a Shoulder Replacement Last?
With advances in surgical techniques and shoulder implants, a shoulder replacement may provide 15-20 years or more of functional life and pain relief.