What is the shoulder?
The shoulder joint is very complex and involves three bones and more than one joint. The bones that make up the shoulder are the clavicle (collar bone), the scapula (shoulder blade), and the humerus (upper arm bone). Many different muscles attach to these different bones. 17 different muscles attach to the scapula alone. The upper end of the arm bone (humerus) and the outside edge of the scapula bone (glenoid) form a “ball-and-socket joint”. What’s the purpose of having such a complex joint? The purpose is to allow a wide range of motion but still have a stable joint that can allow us to lift heavy objects and do a wide range of activities from handstands to holding our children.

When do I need a shoulder replacement?

Osteoarthritis is a condition in which the smooth surfaces (cartilage) of the ball and socket become rough and dry. This causes the ball and socket to rub against each other rather than glide. This rubbing causes pain which in turn leads to stiffness and swelling. Typically, this process occurs over many years. This causes patients to develop chronic pains and stiffness that limits their daily activities. A shoulder replacement is performed to improve your function and quality of life by improving your pain and range of motion.

How successful is shoulder replacement?

In the right patient shoulder replacement is a very successful procedure. Typically, patients go from being able to raise their arm from below shoulder level to above shoulder level after surgery. Rotation also typically improves with surgery however the amount is variable and dependent on many factors including the type of implant used.

What are the types of shoulder replacement?

The two most common types of shoulder replacement are an anatomic shoulder replacement and a reverse total shoulder replacement. With an anatomic total shoulder replacement, the ball (humeral head) of the shoulder joint is replaced with an implant that includes a stem with a smooth, rounded metal head. The socket (glenoid) is replaced with a smooth, specialized plastic. In essence the diseased cartilage is removed and resurfaced with the two components. In some cases, just the ball is replaced, which is called a partial replacement or hemiarthroplasty. With a reversed total shoulder replacement, the normal structure of the shoulder is “reversed.” The ball portion of the implant is attached to the scapula (where the socket normally is) and the artificial socket is attached to the humeral head (where the ball normally is). This allows the stronger deltoid muscles of the shoulder to take over much of the work of moving the shoulder, increasing joint stability. A reversed procedure is typically used for patients with a compromised rotator cuff. It is also commonly used in revision surgery cases.

Damon A. Greene, MD, FAAOS  is a Board Certified Orthopedic Surgeon at Shore Orthopedic University Associates and sees patients in Somers Point, Galloway and Cape May Court House, NJ.

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The information provided in this article is for general informational and educational purposes only and is not intended as, and shall not be understood or construed as, medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

For more information, visit our website: shoreorthodocs.com
To schedule a consultation with Dr. Greene, please call 609-927-1991

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