By Joseph Mileti, M.D.

You can perform a total shoulder replacement? Hearing this inquisitive response is not uncommon when the concept of shoulder replacement surgery is presented to a patient or, surprisingly, even a primary care physician. Although not as common as total hip and knee replacements, shoulder arthroplasty has a comparable history and excellent results for patients suffering from shoulder arthritis.

Arthritis can arise in the shoulder for various reasons. Primary osteoarthritis is the most common cause, but the shoulder can be affected by rheumatoid arthritis, post-traumatic arthritis, avascular necrosis and arthritis secondary to chronic irreparable rotator cuff tears.

Evolution of the Shoulder Replacement Procedure

Shoulder replacements began in the 1950’s for the treatment of complex fractures. In the 1970’s, Dr. Charles Neer pioneered the use of shoulder replacement surgery for the treatment of arthritis. Various design modifications have been adopted over the past 30 years, but the basic principles remain the same. The humeral head (ball) is replaced by a metal stem with a metal ball attached and the glenoid (socket) is replaced by a plastic liner. This liner gives the joint a smooth surface for pain relief and shoulder motion.

Benefits of Shoulder Replacement

Results of shoulder replacement compare favorably to that of hip and knee replacement with 90 to 95 percent of patients achieving good or excellent pain relief. Function is significantly improved for most patients. Some activity limitations are recommended, such as a 50-pound lifting restriction, but patients can resume activities such as golf, swimming and recreational tennis a few months after surgery. In addition, the replacements are very durable with approximately 90 percent last at least 15 years.

While not as well known as hip and knee replacements, shoulder replacement surgery can provide significant and reproducible improvements in the daily lives of patients who suffer from shoulder arthritis.