Shoulder Arthroplasty (Replacement)

Arthroplasty is the most definitive method to manage the pain associated with severe glenohumeral arthritis. Since 1893, when the first shoulder replacement was performed, shoulder arthroplasty has continued to improve with advances in component materials, instrumentation, and surgical techniques.

Good candidates for shoulder arthroplasty are older patients who will place minimal demands on the shoulder and have no rotator cuff damage.

A total shoulder arthroplasty involves the replacement of both sides of the glenohumeral joint (the humerus and the glenoid). A hemiarthroplasty replaces the humeral head only, and is the treatment of choice when replacement of the glenoid is not advised. The surgeon will recommend a procedure based upon the nature and degree of the patient's arthritis.

Those who should not have shoulder arthroplasty:

Contact athletes and heavy laborers are not good candidates for shoulder replacement because of the long-term demands they place on the shoulder.
Total shoulder arthroplasty is not recommended for patients with large, inoperable rotator cuff tears. Since the rotator cuff muscles hold the humeral head tightly to the glenoid, these tears would allow too much movement of the humeral component leading to abnormal loading and loosening of the glenoid component.
Glenoid replacement is not recommended for patients with isolated humeral head arthritis and normal glenoid cartilage, or those with poor glenoid bone quality.
Patients with an active infection in the shoulder joint should not have shoulder arthroplasty.

**Total Shoulder Replacement**

Start Over Click on image to view Total Shoulder Replacement process.

Shoulder arthroplasty is a technically demanding procedure, and the patient should take care to choose an experienced surgeon who has a thorough understanding and knowledge of anatomic and biomechanical principles.

During surgery, the surgeon will:

Maximize the visual field by appropriately placing incisions and using a good retractor system.
Maximize the range of joint motion following surgery by removing osteophytes and releasing the joint capsule, if necessary.
Achieve optimal stability and motion with anatomically correct bone cuts.
Minimize the chances of post-operative complications with proper recognition and treatment of deficient bone and soft tissue.
Allow for a quicker rehabilitation and a faster return to activity with a strong repair during closure of the procedure