Shoulder Joint Replacement

The shoulder is a ball-and-socket joint in which the ball of the upper arm bone (humeral head) fits into a shallow socket in the shoulder blade (glenoid). At their contact points, the bone surfaces are coated with articular cartilage, which allows the bones to glide smoothly against each other during movement. Through trauma or ongoing wear and tear, this protective cartilage can break down and wear away, leading to painful bone-on-bone contact.

If you have disruptive shoulder pain that has not improved with conservative treatment, such as physical therapy and medications, your physician may suggest that you consider a shoulder joint replacement. First performed in the 1950s to treat severe shoulder fractures, this procedure has advanced significantly over the years and is now used to treat many other painful shoulder conditions, including osteoarthritis, rheumatoid arthritis and rotator cuff tear arthropathy.

The types of shoulder joint replacement include:

Total Shoulder Joint Replacement

A conventional shoulder joint replacement involves replacing the damaged joint surfaces with a highly polished metal ball attached to a stem, which is press-fit into the upper arm bone, and an all-plastic socket, which is secured to the shoulder blade with bone cement. This approach may be considered for treating shoulder osteoarthritis if the rotator cuff tendons are intact.

Stemmed Hemiarthroplasty

A traditional, or stemmed, hemiarthroplasty involves replacing the humeral head with a metal ball and stem similar to the component used in a total shoulder joint replacement. However, the glenoid is not replaced. This approach may be considered for treating a severely fractured or arthritic humeral head if the cartilage surface of the glenoid is healthy and intact.

Resurfacing Hemiarthroplasty

A resurfacing hemiarthroplasty involves replacing the surface of the humeral head with a cap-like prosthesis without a stem. This bone-preserving approach may be considered if the humeral head or neck does not have a fresh fracture and the cartilage surface of the glenoid is healthy and intact.

Reverse Total Shoulder Joint Replacement

A reverse total shoulder joint replacement involves swapping the positions of the ball and the socket. A plastic socket is attached to the upper arm bone and a metal ball is attached to the shoulder blade, allowing the patient to use the deltoid muscle instead of the rotator cuff to lift the arm. This approach may be considered for treating a completely torn rotator cuff that is causing severe arm weakness.

Many people achieve an excellent outcome from shoulder joint replacement surgery, including less pain, improved motion and strength and better function. If you would like to learn more, contact Nirschl Orthopaedic Center at (703) 525-2200 to schedule an appointment with a shoulder specialist in Arlington, VA.