Shoulder replacement can be a wonderful treatment option in the appropriately selected patient. Under the guidance of a shoulder specialist like Dr. Thomas S. Obermeyer, you can rest assured your care is among the best. He is subspecialty trained in shoulder replacement and is the area expert in this field. Make an appointment online or over the phone with Dr. Obermeyer to determine if shoulder replacement is right for you.
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Shoulder replacement is an increasingly common operation in the United States and is a large part of Dr. Obermeyer’s practice. The technology for shoulder replacement has improved vastly in recent years and is increasingly used for different forms of shoulder problems. Although not nearly common as hip or knee replacement, shoulder replacement can be equally effective at improving pain and function of the shoulder when other nonsurgical methods have been ineffective.
The most common shoulder problems requiring shoulder replacement are wear and tear of the shoulder joint known as osteoarthritis and other tendon disorders that are beyond repair. These conditions become more common as patients age, although can be seen in younger patients as well. Dr. Obermeyer will carefully review your condition and X-rays with you and discuss what options would be most appropriate in your specific case.
Shoulder replacement is performed through a cut in the front of the shoulder that is a few inches long. There are two forms of shoulder replacement and each is utilized for different conditions.
The first (and historically only) type of shoulder replacement is called a total shoulder replacement where the arthritic bones of the ball and socket are resurfaced with a metal ball and a plastic socket. This improves pain and motion in the previously arthritic joint. To work correctly, this type of shoulder replacement is entirely dependent on the rotator cuff or series of tendons that hold and contain the metal ball in alignment within the socket.
The second and newer type of shoulder replacement is called a reverse replacement which has become available only more recently in America and was initially performed exclusively in France. This replacement flips or inverts the parts so that the plastic socket is located on the arm (humerus) bone and the ball is placed on the previous (glenoid) socket. The function of this replacement does not depend on the small shoulder tendons and has revolutionized the treatment for arthritic conditions with a dysfunctional or irreparable rotator cuff. Dr. Obermeyer specializes in reverse (and conventional total) replacement and is active in improving the design of the instruments and implants as well as in the education of other surgeons who are learning the technology.
Most patients go home following shoulder replacement after a brief hospital stay, although improvements in post-surgical pain management have allowed some patients to leave the surgical facility the same day. Nerve “blocks” which are administered by the anesthesiologist to deaden the pain are very effective following surgery. The recovery typically involves a sling for several weeks, during which time the tissues heal and the surgical pain improves. Within a few days patients can resume showering and simple daily activities with the hand, and physical therapy is started while the sling is worn. Most of the pain improvement is achieved within a few weeks of surgery, which can be surprisingly fast for many patients. There are subtle improvements in pain and use of the arm up to 6 months and beyond.
As with any operation, there are several risks involved but Dr. Obermeyer, your anesthesiologist, and the surgical facility go to great lengths to minimize these risks to make them very infrequent. Dr. Obermeyer will review the risks of surgery in detail with you and the steps that are done to minimize each risk. Do not hesitate to ask questions at your consultation to ensure they are answered to your satisfaction.