Shoulder Replacement Surgery

Shoulder pain and mobility issues can disrupt every facet of life, from lifting groceries to participating in sports or even simple tasks like brushing your hair. If persistent discomfort or restricted movement stemming from a misaligned or damaged shoulder joint is holding you back, you might consider shoulder replacement surgery. But is it the right choice for your condition?

This guide delves deep into the causes of shoulder alignment issues, non-surgical treatment options, and the ins and outs of shoulder replacement surgery. By the end, you’ll understand whether this procedure aligns with your needs and goals.

What Causes Shoulder Alignment Issues?

The shoulder is one of the most complex joints in the human body, capable of a wide range of motion. However, this versatility also makes it prone to alignment issues. These problems often result from structural or functional damage to the joint or surrounding tissues.

Common Causes of Misalignment

Arthritis

Arthritis, particularly osteoarthritis, is a leading cause of shoulder joint misalignment. Over time, cartilage wears away, causing bones to grind against one another, leading to pain, stiffness, and swelling. Rheumatoid arthritis, an autoimmune condition, exacerbates this by causing joint inflammation and eventual deformity.

Rotator Cuff Tears

The rotator cuff, a group of muscles and tendons, stabilizes the shoulder joint. Severe or untreated tears weaken this support system, leading to instability, misalignment, and, often, significant loss of function and strength in the affected arm.

Injury or Trauma

Shoulder dislocations, fractures, or repetitive strain injuries can physically alter the joint’s structure. For instance, a dislocation might overstretch ligaments, while fractures can lead to permanent bone misalignment if not appropriately treated.

Chronic Shoulder Instability

Over time, repeated shoulder dislocations or injuries can stretch or damage the joint capsule and surrounding tissues, leading to a persistent feeling of the joint “slipping” out of place during movement.

Without proper treatment, these conditions often worsen over time, resulting in pain, stiffness, and decreased quality of life.

Shoulder replacement surgery, or shoulder arthroplasty, is typically considered a last resort for patients whose symptoms persist despite exhaustive non-surgical treatments. You might be a candidate if:

• Pain significantly interferes with your daily life. Sleeping, dressing, or working becomes difficult due to chronic pain or stiffness.
• Imaging tests reveal severe damage. X-rays or MRIs may show advanced cartilage loss, bone spurs, or joint deformities that cannot be addressed through conservative treatments.
• Non-surgical treatments have been ineffective. If therapy, injections, or medications no longer offer relief, surgery may be the next logical step.
• You have advanced arthritis with additional complications. Severe osteoarthritis or rheumatoid arthritis that affects surrounding structures, like the rotator cuff, often necessitates surgical intervention.

Types of Shoulder Replacement Surgery

There are three main types of shoulder replacement procedures, each designed to address specific conditions and levels of damage.

Total Shoulder Replacement

This procedure replaces both components of the shoulder joint:

• The humeral head (ball), and 
• The genoid (socket). 

It is most effective for patients with arthritis but an otherwise healthy rotator cuff. This procedure:

• Restores smooth joint surfaces using metal and plastic implants,
• Reduces pain and stiffness by eliminating bone-on-bone friction, and
• Improves mobility when paired with a strong rehabilitation program.

Reverse Shoulder Replacement

In reverse shoulder replacement, the ball-and-socket configuration of the shoulder is reversed:

• The ball is attached to the shoulder blade (scapula).
• The socket is attached to the upper arm bone (humerus).

This surgery is ideal for patients with severe rotator cuff damage because it:

• Relies on the deltoid muscle instead of the damaged rotator cuff for arm movement, and
• Provides stability to shoulders affected by chronic dislocations or weakness.

Partial Shoulder Replacement (Hemiarthroplasty)

In a partial replacement, only the damaged portion of the joint is replaced—typically the humeral head. This option is best suited for:

• Isolated fractures, such as those limited to the ball portion of the joint, and
• Patients with good cartilage condition on the glenoid side of the joint.

Each of these surgeries has its indications, benefits, and potential risks, which your orthopedic surgeon will discuss in detail to help you make an informed decision.

Exploring Non-Surgical Treatment Options

If your shoulder pain doesn’t warrant surgery but you feel discomfort day-to-day, some can find relief through non-surgical interventions. These treatments are typically recommended as the first line of defense, especially for mild to moderate cases.

Physical Therapy

Physical therapy is one of the most effective ways to address alignment issues. A trained therapist can guide you through exercises designed to:

• Strengthen supporting muscles. Improving the strength of muscles like the deltoid or rotator cuff can enhance joint stability and alignment.
• Increase flexibility. Stretching targeted areas can help reduce stiffness and restore the joint’s natural range of motion.

Check to see if physical therapy can be covered with insurance. 

Medications

Over-the-counter or prescription anti-inflammatory medications can help reduce swelling and alleviate discomfort. These include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen and naproxen, which are effective for reducing mild to moderate inflammation.
• Disease-modifying antirheumatic drugs (DMARDs). For patients with rheumatoid arthritis, these medications can slow the disease’s progression.

Consult with a doctor before taking any medications. 

Corticosteroid or Hyaluronic Acid Injections

For patients with severe inflammation or chronic pain, injections may provide temporary relief.

• Corticosteroids. These injections reduce inflammation and are often used for arthritis or bursitis.
• Hyaluronic acid. This substance mimics joint fluid, improving lubrication and cushioning within the shoulder.

Injections require a prescription from your doctor. 

Lifestyle Adjustments

Making changes to your daily routine can have a significant impact on shoulder health:

• Ergonomic tools. Using equipment that minimizes strain on the shoulder can reduce aggravation during work or hobbies.
• Postural improvements. Maintaining proper posture reduces unnecessary stress on the joint.

While these approaches can be effective for certain individuals, they are often insufficient for those with severe damage or chronic alignment issues. This is when surgical options come into play.

Reach out for More Information

Shoulder replacement surgery is a highly effective solution for individuals struggling with severe shoulder alignment issues, arthritis, or chronic pain. It offers the potential for lasting relief, improved mobility, and a better quality of life. However, the decision to proceed should be made carefully in consultation with a skilled orthopedic professional.

At Ayaz A. Biviji, MD, we are dedicated to helping you find the best path to recovery. With years of experience in shoulder care and a patient-centered approach, we work with you to create a personalized treatment plan.

Ready to take the next step? Contact us today to schedule your consultation and move toward a life free from shoulder pain!