Shoulder replacement surgery in Denver
The Orthopedic & Spine Center at Rose Medical Center treats a range of shoulder conditions that may or may not ultimately require shoulder replacement surgery. Shoulder replacement surgery is an option for patients with shoulder pain, weakness or limited range of motion. For these patients, shoulder pain can be debilitating and prevent the ability to perform daily tasks and live an active lifestyle.
Our board-certified shoulder surgeons are committed to improving each patient’s quality of life by developing an individualized treatment plan that guides the patient from diagnosis through treatment and recovery.
To schedule an appointment with one of our shoulder experts, please call the Rose Orthopedic & Spine Center physician referral line at (303) 374-0755.
Common shoulder conditions
These conditions of the shoulder joint may indicate that you require specialized shoulder care:
- Osteoarthritis or degenerative joint disease
- Rheumatoid arthritis
- Post-traumatic arthritis
- Rotator tear arthropathy (a combination of severe arthritis and a massive non-reparable rotator cuff tendon tear)
- Severe fractures
- Avascular necrosis (osteonecrosis)
- Failed previous shoulder replacement surgery
Am I a candidate for shoulder replacement?
If you are considering shoulder replacement surgery, our orthopedic team will perform a physical exam, imaging tests and review your medical history to determine if you are a candidate for surgery. Generally, patients are considered for a shoulder replacement if one or more of the following are present:
- Pain in the front, back or top of the shoulder
- Radiating pain down the upper arm
- Weakness that makes carrying and lifting objects difficult
- Difficulty with overhead activities, like reaching for items high in the kitchen cabinets
- Pain preventing restful sleep at night
- Decreased shoulder range of motion making dressing and grooming problematic
- Difficulty reaching for items or behind your back
- Popping, catching or grinding in the joint during shoulder movement
- Pain is not relieved by conservative methods of treatment, such as injections, medications or therapy
- X-rays show advanced arthritis or other problems
There are no age restrictions when it comes to being eligible for a shoulder replacement. While most shoulder replacement surgery patients are between 60 and 80 years old, patients outside that range may qualify. More consideration is given to the patient’s symptoms, the cause of the shoulder pain or discomfort and whether more conservative treatments have worked.
The style of shoulder replacement that is used for any patient is dependent on the patient’s unique anatomy, medical history and bone quality.
Treating shoulder pain
Once the source of your shoulder pain is identified, your surgeon may prescribe anti-inflammatory medication, physical therapy, a cortisone injection or surgery, if your condition is severe enough. At Rose, we offer the following surgical procedures:
- Partial shoulder replacement (hemiarthroplasty)
- Reverse shoulder replacement
- Total shoulder replacement
- Rotator cuff repair
- Labral repair
- Subacromial decompression
- Distal clavicle excision
Partial shoulder replacement
A shoulder hemiarthroplasty, also known as a humeral head resurfacing or partial replacement, is a shoulder replacement where only the humerus portion of the shoulder joint is replaced and the glenoid portion is not changed. A partial replacement is typically recommended for patients that have a good amount of cartilage remaining on the glenoid bone. Shoulder hemiarthroplasties are also done in patients that have severe fractures of the humeral head but have no loss of cartilage on the glenoid.
Reverse shoulder replacement
In a patient that has shoulder arthritis and an irreparable rotator cuff tear or cuff tear arthropathy, a traditional shoulder replacement can leave them with continued pain and limited range of motion because the rotator cuff insufficiency is not improved with the surgery. The better option for this type of patient is a reverse total shoulder replacement because the ball and socket components are switched and this design allows the deltoid muscle to lift the arm since the rotator cuff muscles are unable to do so effectively.
In a reverse total shoulder replacement, the glenoid (shoulder blade) component consists of a metal plate that is anchored in the bone with the screws and a metal ball that is attached to the plate. The humerus (upper arm bone) portion of the prosthesis is composed of a plastic liner that locks into a metal stem creating the socket that articulates with the metal ball on the glenoid. The metal stem is implanted in the top of the humerus bone and the component is either cemented in place or impacted (press-fit) in the bone. Patients that have had a previous unsuccessful traditional total shoulder replacement may also benefit from converting the joint replacement to a reverse total shoulder arthroplasty.
Total shoulder replacement
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 humeral component is composed of a metal ball that is attached to a metal stem, which is cemented or impacted into the top of the humerus bone.
The metal ball fits within the plastic glenoid component allowing smooth motion of the shoulder joint once again.
Most patients who undergo a shoulder replacement spend one to two nights in the hospital to work on gentle range of motion with a physical therapist, activities of daily living with an occupational therapist and to find an adequate pain medication regimen. Based on the nature of joint replacement surgery, most patients experience a moderate amount of bruising and swelling of the affected arm, and occasionally, the chest.
Most surgeons will have their patients wear a sling for at least the first few weeks following surgery. The incision is typically in the front of the shoulder and is usually about six to eight inches long. The first follow-up appointment in the surgeon’s office is typically seven to 10 days after the surgery. Most patients will continue with physical therapy for three or more months postoperatively.
With advances in surgical techniques and shoulder implants, a shoulder replacement may provide 15 to 20 years or more of functional life and pain relief.