An In-Depth Look at Shoulder Replacements

Follow along as sports medicine and shoulder specialist, Dr. Jeff Backes, gives a comprehensive overview of total shoulder replacements. Dr. Backes discusses the signs and symptoms associated with arthritis of the shoulder, the variety of treatment options available for shoulder arthritis, the two different types of total shoulder replacement, and the typical recovery process after surgery. 

What is Shoulder Arthritis? 

 Shoulder arthritis occurs when the cartilage between two bones breaks down, causing them to become bone on bone. When this happens, patients often experience pain, stiffness, or a decrease in mobility. These symptoms may start as a constant ache that tends to worsen in the evening or following physical activity, with the severity increasing as the arthritis progresses. 

 

What are the Treatment Options for Shoulder Arthritis? 

Conservative Treatment Options

  • Physical Therapy: In shoulder patients, physical therapy is typically most effective early on when used as a conservative treatment method 
  • Medication: Over the counter pain relievers and anti-inflammatory medicines 
  • Joint Injections  

Surgical Treatment Options  

If conservative treatments fail, your doctor may recommend one of two surgical procedures to remove the arthritic joint, therefore eliminating the source of pain and improving mobility.  

  • Anatomic Shoulder Replacement
  • Reverse Shoulder Replacement 

What is an Anatomic Shoulder Replacement? 

An anatomic shoulder replacement involves replacing the damaged or diseased head of the humerus and cartilage from the shoulder joint with a metal ball and plastic socket. This type of shoulder replacement surgery is used in cases where the individual has a functioning rotator cuff. 

The procedure takes about one hour and patients typically go home the same day or the following day. 

 

What is the Recovery Process for an Anatomic Shoulder Replacement? 

Following anatomic shoulder replacement surgery, patients will wear a sling for 4-6 weeks. The sling can be removed shortly following surgery to perform daily tasks such as eating, bathing, and dressing. 

 

What is a Reverse Shoulder Replacement?  

During a reverse shoulder replacement, the surgeon replaces a damaged shoulder joint with artificial components that reverse the structure of the shoulder, allowing other muscles to lift and move the arm. This procedure is most often used for patients who have had a complete tear of the rotator cuff. 

Like the anatomic shoulder replacement, this procedure takes close to an hour to complete. While some patients may go home that day, it is more common for reverse shoulder replacement patients to spend a night at the hospital and return home the next day.  


What is the Recovery Process for a Reverse Shoulder Replacement? 

 Reverse Shoulder Replacement patients use a sling for 1-2 weeks following surgery. However, after the first day, they can remove the sling as needed to perform daily tasks. 


Is Physical Therapy Needed After a Shoulder Replacement? 

  • Anatomic shoulder replacement patients rarely need formal physical therapy and typically complete exercises at home following surgery. 
  • About 50 % of reverse shoulder replacement patients benefit from starting physical therapy in the clinic post-op and complete the rest of their therapy at home. The other 50 % stick to at-home exercises throughout their recovery. 

 

Shoulder arthritis is one of the most painful shoulder conditions. Both anatomic and reverse shoulder replacements can restore function and provide pain relief, and the method typically depends on the functionality of the rotor cuff. After a shoulder replacement, most patients can complete daily tasks pain-free and get back to enjoying the activities they love!