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Shoulder Arthritis- What is Shoulder Arthroplasty?

Shoulder arthritis is a common cause of shoulder pain and disability.  Most shoulder arthritis occurs without any discreet trauma and is a progressive disease where the cartilage ( soft cushioning on the joint ) is worn away.   Most patients complain of pain ( particularly, but not always, at night ) as well as decreased range of motion.

Non-operative treatments include anti-inflammatory medications such as ibuprofen or precription longer lasting medications, home exercises to help maintain range of motion, and joint injections ( such as cortisone and viscosupplementation ( gel injections )).

When non-operative treatments fail to provide significant pain relief and functional use of the shoulder and arm, shoulder replacement ( also call arthroplasty ) is considered.  Shoulder replacement is a sugical procedure where small parts of the bones and all of the remaining cartilage in the shoulder joint are removed and replaced with metal and hihg-grade plastic components. This helps restore shoulder mobility and function and mobility of the shoulder and significantly decreases pain.  

Shoulder replacement implants come in two general varieties, anatomic or reverse total shoulder replacement.  Anatomic is used when the patient has intact rotator cuff muscles and tendons as these are needed to help stabilize the native shoulder and a shoulder replacedment.   If a person has poor rotator cuff muscles and tendons or they are torn, then a reverse shoulder replacment is usually recommended as this implant does not require a functioning rotator cuff.  

The shoulder joint is compromised of three bones- the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). These three bones are connected with ligaments and cartilage, which protects the ends of the bones where they meet.  During total shoulder replacement surgery, the humerual head (ball) and the glenoid (socket) surface of the glenoid.  Metal and high-grade plastic components are then placed to re-create the ball and socket.  The procedure usually takes less then 2 hours and most patients opt to stay overnight in the hospital for a day, however it can be done on as an outpatient ambulatory procedure.  

    Author
    William Schell, MD

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