Shoulder Joint Replacement

Are You Considering Shoulder Replacement Surgery?

Circumstances vary, but generally patients are considered for total joint replacement if:

• Functional limitations restrict not only work and recreation, but also the ordinary activities of daily living
• Pain is not relieved by more conservative methods of treatment — such as medications (including, for the shoulder, injections of cortisone, a powerful anti-inflammatory medication) and physical therapy — and/or by restricting activities
• Stiffness in the joint is marked and, in the shoulder, significantly limits range of motion of the arm
• X-rays show advanced arthritis or other problems

Advancements in Shoulder Replacement
If you’re reading this website, chances are you’re considering or preparing for shoulder surgery. That’s good news — because shoulder replacement has been proven to relieve severe shoulder pain and restore function in the vast majority of patients.

And now there’s even better news. Advancements in the design of shoulder prosthesis allow the potential for you to restore your range of motion. Developed with patient comfort in mind, the Solar® Shoulder is designed for a more natural feel throughout range of motion.

The Solar® Shoulder is designed to replicate the natural anatomy of the patient and help provide you with maximum range of motion so you can get back to the activities you enjoy.*

As you read, make a note of anything you don’t understand. Your orthopaedic surgeon will be happy to answer your questions so that you’ll feel comfortable and confident with your chosen treatment plan.

According to the American Academy of Orthopaedic Surgeons, approximately 23,000 people have shoulder replacement surgery each year. Shoulder problems may arise because of injury to the soft tissues of the shoulder, overuse or underuse of the shoulder, or even because of damage to the tissues. Shoulder problems result in pain, which may be localized to the joint or travel to areas around the shoulder or down the arm.

*Individual results vary and not every patient will experience the same post-operative range of motion and results.

Understanding How Shoulders Work

Shoulder Anatomy and Function
The shoulder is the most moveable joint in the body. It is made up of three bones: the collar bone (clavicle), the shoulder blade (scapula), and the upper arm bone (humerus), as well as two important joints that allow for movement. The glenohumeral joint, also known as the shoulder joint, is a ball-and-socket that connects the humerus to the shoulder blade. This joint allows free movement of the arm so that it can rotate in a circular fashion.

The rotator cuff is made up of four muscles and their tendons, which act to hold the upper arm (humerus) to the socket of the shoulder (glenoid fossa). The rotator cuff also provides mobility and strength to the shoulder joint.

A smooth substance called articular cartilage covers the surface of the bones where they touch each other within a joint. This articular cartilage acts as a cushion between the bones.

Shoulder Pain: Causes and Treatments

What Causes Shoulder Joint Pain?
One of the most common causes of joint pain is arthritis. The most common types of arthritis are:

Osteoarthritis (OA)
Sometimes called degenerative arthritis because it is a “wearing out” condition involving the breakdown of cartilage in the joints. When cartilage wears away, the bones rub against each other, causing pain and stiffness. OA usually occurs in people aged 50 years and older, and frequently in individuals with a family history of osteoarthritis.

The most common cause of shoulder replacement, OA can occur without a shoulder injury. However, this seldom happens since the shoulder is not a weight-bearing joint like the knee or hip. Instead, shoulder OA commonly occurs many years following a shoulder injury, such as a dislocation, that has led to joint instability and repeated shoulder dislocations — damaging the shoulder joint so that OA develops.

Rheumatoid Arthritis (RA)
Produces chemical changes in the joint space that cause it to become thickened and inflamed. In turn, the synovial fluid destroys cartilage. The end result is cartilage loss, pain, and stiffness. RA affects women about 3 times more often than men, and may affect other organs of the body.

Post-traumatic Arthritis
May develop after an injury to the joint in which the bone and cartilage do not heal properly. The joint is no longer smooth, and these irregularities lead to more wear on the joint surfaces.

Other causes of joint pain include avascular necrosis, which can result when bone is deprived of its normal blood supply (for example, after organ transplantation or long-term cortisone treatment), and deformity or direct injury to the joint.

Having an Orthopaedic Evaluation
While every orthopaedic evaluation is different, there are many commonly used tests that an orthopaedic specialist may consider in evaluating a patient’s condition. The orthopaedic evaluation usually consists of:

• A thorough review of your medical history
• A physical examination
• X-rays
• Additional tests as needed. These may include laboratory testing of blood, urine, or joint fluid and/or a bone scan of the joint and surrounding soft tissue.

Treatment Options
Following an orthopaedic evaluation, the orthopaedic specialist will review and discuss the results with you. Based on his or her diagnosis, your treatment options may include:

• Medications, which may include cortisone injections for temporary pain relief
• Physical therapy
• Shoulder joint fluid supplements (injections that provide temporary pain relief)
• Shoulder joint replacement

If you and your orthopaedic specialist decide that shoulder joint replacement surgery is an option to relieve your pain, the orthopaedic specialist will provide the details of which type of artificial joint he or she will use, what you need to know to prepare for the surgery, how the surgery will be performed, and what results you can expect after the surgery.