Your shoulder joint is composed of four joints and three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humorous (upper arm bone). An edge of the scapula, called the acromion, forms the top of the shoulder. Your shoulder happens to encompass the most movable joints in your body, but can become unstable and the site of many injuries, such as sprains, strains, dislocations, separations, torn rotator cuffs, bursitis, tendonitis, frozen shoulder, fractures and arthritis. So what are your shoulder replacement options?
In 2006, research showed that approximately 7.5 million people went to the doctor’s office for a shoulder problem, including shoulder and upper arm sprains and strains. Shoulder injuries are frequently caused by athletic activities that involve excessive or repetitive overhead motion.
Most problems in the shoulder involve the muscles, ligaments, and tendons, rather than the bones. Arthritis, injury, and repetitive motions such as those used during sports or work-related activities are the leading causes of shoulder or elbow pain, stiffness, and restriction of movement. Athletes are especially susceptible to shoulder problems. Shoulder problems for athletes can often develop slowly, through repetitive and intensive training routines. People may also underestimate the extent of their injury, where it almost becomes second nature the longer you live with steady pain, weakness in the arm, or limitation of joint motion. There are two categories of shoulder injuries – instability and impingement.
What’s the difference between a standard total shoulder replacement and a reverse total shoulder replacement?
In standard total shoulder replacement surgery, a metal ball is used to replace the head of the humorous. A high-strength plastic implant is used to replace the socket of the shoulder blade.
In reverse total shoulder replacement surgery, the location of the new ball and socket are on the opposite sides of a normal shoulder. Their positions are “reversed.” A new metal hemisphere is used to replace the socket of the shoulder blade, and a metal and high-strength plastic socket are used to replace the head of the humorous.
Which surgery is best?
The primary goal of both approaches is to relieve pain. Secondary goals are to improve motion, strength and function. Before any decision is made regarding the type of surgery, all nonsurgical options are approached first. Medications and physical therapy are tried first, and if the pain is still not significantly reduced, total shoulder replacement surgery is then considered.
The degree of damage to the rotator cuff is one of the key factors in deciding which type of total shoulder replacement surgery is the better option. Although standard shoulder replacement surgery reduces or eliminates pain and improves function, success depends on the condition of the rotator cuff. The more intact the rotator cuff is, the better the outcome.
Reverse total shoulder replacement surgery is the best option for patients with severe arthritis and a large rotator cuff tear. Despite the large rotator cuff tear, the change in position of the joint improves shoulder function and replacing the joint removes any arthritis. More than 90 percent of patients experience significant improvement in both shoulder pain and function, including the ability to raise their arm above the head.
To find out more information on whether Standard or Reverse Shoulder Replacement is right for you, call Colorado Center of Orthopaedic Excellence to request an appointment.