TOTAL SHOULDER ARTHROPLASTY

ABOUT TOTAL SHOULDER REPLACEMENT

Total shoulder arthroplasty (TSA), commonly referred to as shoulder replacement surgery, is a surgical procedure designed to alleviate chronic shoulder pain, restore shoulder function, and improve the quality of life for individuals with severe shoulder joint damage or degeneration. It involves the removal of damaged or diseased parts of the shoulder joint and their replacement with artificial components. Here’s a comprehensive overview of total shoulder arthroplasty, including specific procedures, modern advancements, and important considerations:

Indications: Total shoulder arthroplasty is typically considered when conservative treatments like medications, physiotherapy, and lifestyle modifications no longer provide sufficient relief for the following conditions:

• • • Osteoarthritis: Degeneration of the shoulder joint due to wear and tear.
    • Rheumatoid arthritis: An autoimmune condition affecting the shoulder joint.
    • Post-traumatic arthritis: Resulting from a severe shoulder injury.
    • Rotator cuff tear arthropathy: Associated with a chronic rotator cuff tendon tear.

Surgical Procedure: Total shoulder arthroplasty is typically performed under general or regional anesthesia. The procedure involves several key steps:

1. 1. Incision: An incision is made over the shoulder joint to access the damaged area.
   2. Shoulder Joint Exposure: Muscles and soft tissues are carefully moved aside to access the shoulder joint.
   3. Reshaping Bones: The damaged humeral head (the upper arm bone’s ball) is removed.
   4. Implants: Artificial components are inserted. These typically include a humeral component (metal stem with a ball), glenoid component (plastic or metal socket), and sometimes a plastic or metal liner.
   5. Stabilization: The surgeon ensures proper alignment and stability of the artificial shoulder joint components.
   6. Closure: The incision is closed with sutures or staples.

Modern Advancements: Modern total shoulder arthroplasty has benefited from various advancements:

• • • Minimally Invasive Techniques: Smaller incisions and specialized instruments reduce scarring, pain, and recovery time.
    • Reverse Total Shoulder Arthroplasty: This specialized technique is used for certain complex shoulder conditions, providing better stability and function in patients with compromised rotator cuffs.
    • Advanced Implant Materials: Implant components made of durable materials like metal and  polyethylene improve longevity and minimize wear.
    • Patient-Specific Implants: In some cases, customized implants based on a patient’s unique anatomy can enhance fit and function.
    • Enhanced Pain Management: Techniques such as nerve blocks and multimodal pain control help manage post-operative discomfort.

Recovery and Rehabilitation:

• • • After surgery, patients undergo physical therapy to regain shoulder strength, flexibility, and mobility.
    • You will refer to your post-op protocol from your surgeon but weight-bearing and range-of-motion exercises typically begin within a day.
    • Full recovery may take several months, with improvements continuing for up to a year.

Benefits of Total Shoulder Arthroplasty:

• • • Relief from chronic shoulder pain.
    • Improved shoulder joint function and mobility.
    • Enhanced quality of life, allowing individuals to engage in daily activities and hobbies.
    • Long-lasting results, with many shoulder replacements providing pain relief and function for years.