Shoulder Replacement Specialist in San Juan Capistrano, Fountain Valley CA
Arthritis of the shoulder can cause pain, swelling and stiffness in the joint. The condition is treated by removing the damaged articulating parts and replacing them with prostheses. Dr. Sohn provides expert diagnosis and individualized non-operative and operative treatments for the shoulder including shoulder joint replacement in San Juan Capistrano, Fountain Valley CA. Dr. Sohn also provides highly specialized care during and after surgery. Contact Dr. Sohn’s team for an appointment today!
What is a Total Shoulder Joint Replacement?
By Roger Sohn, MD
Total shoulder replacement surgery is performed to relieve symptoms of severe shoulder pain and disability due to arthritis. In this surgery, the damaged articulating parts of the shoulder joint are removed and replaced with artificial implants that mimic the native shoulder. Replacement of both the humeral head and the socket is called a total shoulder replacement.
The shoulder is a highly movable body joint that allows various movements of the arm. It is a shallow ball and socket joint, where the head of the humerus (upper arm bone) articulates with the socket called the glenoid. Normally, the two articulating surfaces of the bones are covered with cartilage, which prevents friction between the moving parts. The cartilage is lubricated by synovial fluid. Tendons and ligaments around the shoulder joint provide strength and stability to the joint.
What is Arthritis?
For various reasons, the protective cartilage surfaces of the bones can become damaged and thin. As damage accumulates, the underlying bone surfaces become exposed and rub against each other causing pain, swelling and stiffness of the joint. This condition is called arthritis. There are several types of arthritis. Osteoarthritis (wear-and-tear) and rheumatoid arthritis (autoimmune disease) are two forms of arthritis.
When is Shoulder Joint Replacement Called For?
Total shoulder joint replacement is a surgery indicated for conditions such as osteoarthritis or rheumatoid arthritis. The surgery is a good option when conservative measures such as anti-inflammatory medication, cortisone injections, and activity changes fail to relieve pain. Patients often find the surgery a good choice when their shoulder pain is causing them to restrict their activities or if the pain gets so bad that even common activities become difficult to do. A total shoulder replacement can often restore the normal function of the shoulder, allowing patients to return to the activities they enjoy.
Preparation for Shoulder Joint Replacement
When I see patients in consultation, I ask a lot of questions about their symptoms and their medical history. A thorough physical examination of the shoulder and imaging tests such as X-ray and CT scans can help in formulating a treatment plan. We discuss the various options and risks of the alternatives. We will often prescribe an antimicrobial gel for patients to use prior to surgery. This helps to cut down on the risk of an infection. Patients are given instructions on sling use and the restrictions they need to observe in the postoperative period.
How is the Shoulder Replacement Done?
The surgery is usually done at a hospital or surgery center as an outpatient procedure. Some patients are kept for overnight observation, but most patients are discharged after surgery to recover at home. The surgery is performed under general anesthesia with the additional placement of a nerve block so the shoulder feels numb for the first day after surgery. An incision is made over the affected shoulder and the underlying muscles are separated to expose the shoulder joint. We remove the arthritic bone spurs and prepare the humerus to receive the artificial ball. We place a plastic component on the socket side with bone cement and then we close the layers of the wound. Patients are taken to the recovery unit and monitored prior to discharge. The entire surgery takes about 90 minutes.
How Do I Care for the Shoulder After Surgery?
After the surgery, patients are expected to take narcotic pain medications for the first several days. The arm is placed in a sling which can be removed several times a day to do gentle “pendulum exercises”. These are safe and gentle exercises that keep the shoulder moving to avoid stiffness. No forceful internal rotation or lifting is allowed for the first 6 weeks. This allows the bicep and subscapularis tendons to heal. The rehabilitation program includes physical therapy, which is started about a week after the surgery. Initial visits focus on flexibility. You may be able to perform gentle daily activities two to six weeks after surgery. If all looks well at the 6-week mark postoperatively, more vigorous therapy can start. Most all restrictions are removed at the 3-month mark after surgery.
What are the Risks and Complications of Shoulder Joint Replacement?
As with any major surgery, there are risks involved:
- Anesthetic complications such as cardiac or cerebral events.
- Infection of the wound
- Dislocation, requiring repeat surgery
- Damage to blood vessels, nerves or muscles
- Failure to relieve pain
- Blood clots
- Early loosening of the prosthesis
These risks are fairly rare but they must be considered prior to making the decision for surgery.
What are the Results After Shoudler Replacement:
We track patient rated outcomes after surgery. To learn more about our outcomes, please click here.
To schedule a consultation with Dr. Sohn and his team, please call or contact us.
Dr. Roger Sohn discusses new advancements in the treatment of shoulder arthritis.