Can a Shoulder be Replaced?

Dr. Nathan Everding

NATHAN EVERDING, MD

The answer is YES! More importantly, shoulder replacement works! 

Many people have experienced, or know someone who has experienced, joint replacement surgery.  Knee and hip joint replacements are some of the most common orthopedic procedures performed today.  Amazingly, the first reports of hip and shoulder replacements originated in Europe over a century ago.  Modern hip replacement surgery was pioneered by Sir John Charnley, MD (1911–1982) in England in the 1960’s.  Since that time, hip and knee replacements have evolved to become commonly performed and successful orthopedic procedures. 

Meanwhile, shoulder replacement surgery was pioneered in New York City by Dr. Charles S. Neer, II (1917-2011).  He began performing shoulder replacements in the 1950s and since then, shoulder replacement surgery has undergone significant technological advancements.  Implant designs and surgical techniques have greatly improved leading to enhanced patient outcomes after surgery.  Shoulder replacement is actually the fastest growing division of joint replacement surgery!

Shoulder osteoarthritis, with associated pain and dysfunction, is the most common reason for shoulder replacement surgery.  Common symptoms of shoulder arthritis include:

    • Pain (often located deep in the shoulder or on the outside over your deltoid muscle)
      • The pain is worse with activity and shoulder motion
      • The pain  is often worse at night and makes sleeping difficult
      •  Pain is progressive and worsens gradually over time
    • Loss of motion
      •  You may notice that you cannot reach as high, or as far out, with your arthritic shoulder
    • Grinding and Crepitus
      • You may experience popping, crunching, or clicking sounds with motion
    • Atrophy
      •  Your muscles may get smaller from lack of use
    • Swelling and Tenderness
      • You may notice swelling and tenderness around your shoulder
      • This is likely due to inflammation from the arthritis
    • Difficulty with activities
      • All of the above symptoms can make even simple daily activities (grooming, getting dressed, bathing, driving) difficult to perform
      • Patients often have to modify their activities and predominantly use their other arm

Patients with arthritis are often treated conservatively at first, with the goals of improving pain and function.  Conservative treatments include activity modification, anti-inflammatory medications (ibuprofen, naproxen, meloxicam, etc.), cortisone injections, and physical therapy.  Shoulder replacement should be considered when conservative treatment stops working and pain and dysfunction affect your quality of life.

Shoulder arthritis typically affects people as early as 50-60 years old.  Shoulder replacements can be performed safely even when arthritis occurs after the age of 80 years old.

Following surgery patients can expect reliable and significant improvements in pain, motion, and function after shoulder replacement surgery.  Many patients regain their independence and activity with significant improvements in their quality of life.  Many clinical studies have demonstrated these improvements, and most show that 90-95% of patients consider their surgery a success.  Patients can even get back to playing sports (swimming, tennis, golf, skiing, etc.) and many patients will improve their ability to participate in these activities.  Most shoulder replacements will provide reliable function and pain relief for 15-20 years.

Recovery after shoulder replacement surgery typically involves a period of time (about 6 weeks) in a sling and limited activity for 3 months while the replacement heals.  After 3 months patients can start to strengthen their shoulder and return to their activities.  During the recovery period light stretching activities are utilized to help prevent stiffness and regain range of motion.

Shoulder replacements can also be utilized to treat other types of arthritis and injuries such as rheumatoid arthritis, post-traumatic arthritis, dislocations, fractures, and even irreparable rotator cuff tears.