Frisco & Dallas Shoulder Replacement

Arthritis is a major cause of pain, stiffness, and swelling in the shoulder. Arthritis can occur for many reasons, including aging, “wear and tear,” injury, autoimmune disease, and inflammatory disease. There are over 100 different types of arthritis. Osteoarthritis, post-traumatic arthritis, and rheumatoid arthritis are the ones that frequently develop in the shoulder.

Osteoarthritis tends to develop as people age. It causes the cartilage covering the end of the bones to gradually wear away resulting in painful bone-on-bone rubbing. Abnormal bone growths, called spurs, can grow in the joint. The bone spurs add to the pain and swelling while disrupting movement.

Post-traumatic arthritis can develop in individuals of all ages after a shoulder injury, such as a fracture. 

Rheumatoid arthritis is one of the most serious and disabling types of arthritis. It can affect people of all ages, but most frequently occurs in women and those over the age of 30. It is a long-lasting autoimmune disease that causes painful inflammation of the synovium. Rheumatoid arthritis also causes joint swelling and deterioration and can affect issues surrounding the joint. Pain, stiffness, and swelling are usually ongoing symptoms, even during rest.

Some people that have had a rotator cuff injury for a long time may develop rotator cuff tear arthropathy. Eventually, arthritis can develop from this, which leads to destruction of the joint cartilage.

Shoulder replacement surgery may also be a treatment for avascular necrosis. This medical condition causes a lack of blood flow to the head of the humerus bone, causing it to die. Avascular necrosis can be caused by several factors, including chronic steroid use, deep sea diving, severe fractures, sickle cell disease, and heavy alcohol consumption.

A deep ache is the primary symptom of shoulder arthritis. Inflammation, swelling, and stiffness are also symptoms. In the early stages of arthritis, your shoulder pain may get worse with movement or activity. As time goes on, the pain may become continuous, becoming severe enough to keep you awake at night and interrupt your ability to do everyday tasks, such as putting on a belt or carrying groceries. 

Arthritis can make your joints feel weak or unstable. Your shoulder may feel like it “grinds” or “catches” when you raise your arm and you may have difficulty moving it. This can make it challenging to complete common activities, such as putting on your shirt or washing your hair.

Your doctor may diagnose arthritis by conducting a physical examination. You will likely be asked to perform simple arm and shoulder movements to help your doctor assess your muscle strength, joint motion, and joint stability. Blood tests and other laboratory tests may identify what type of arthritis you have. 

From there, your doctor will determine whether you require a shoulder replacement. Shoulder arthroplasty is recommended when non-surgical treatments have provided minimal or no improvement of your symptoms.

Your shoulder will need several months to fully recover from the surgery. Your surgeon will restrict your arm movements for a short period of time following your procedure and you will need to wear an arm sling. Our experienced Dallas occupational and physical therapists will help you gently move your arm starting on the first day following your surgery, or even on the day of surgery. You will gradually work to strengthen and increase the movement in your shoulder over time.

Generally, shoulder arthroplasty rehabilitation can take anywhere from three to six months. Ultimately though, your recovery time will depend on the extent of your condition and the amount of surgery that you had. Your surgeon will let you know what to expect. Overall, most people experience an improved quality of life because of the decreased pain and improved function that shoulder arthroplasty allows.

Shoulder replacement surgery is performed as an inpatient procedure; you may expect to stay in the hospital a day or two following your surgery. The surgery itself typically takes a couple hours. Allowing time for the anesthesia and prep before surgery, it will likely fall somewhere around 3 hours altogether. You will either require general anesthesia or a regional nerve block for the procedure. 

There are a few different types of shoulder replacement surgeries. Total shoulder replacement surgery is recommended for people with bone-on-bone osteoarthritis and intact rotator cuff tendons. This is the most common type of shoulder replacement surgery. 

For this procedure, your surgeon will make an incision, approximately six inches long, on the front of your shoulder joint. Your surgeon will replace the damaged head of the humerus with a highly-polished metal ball. The metal ball may be surgically implanted in the humerus or attached with surgical cement, depending on the condition of the bone. The glenoid is replaced with a plastic socket.

In some cases, the surgeon may only replace the head of the humerus in a procedure called a hemiarthroplasty. This procedure is used if the glenoid cartilage is in good condition. A hemiarthroplasty is most commonly used to treat shoulder fractures. 

Another type of surgery is called a reverse total shoulder replacement. A reverse shoulder replacement surgery is recommended for people with completely torn rotator cuffs, severe arthritis with cuff tear arthropathy, or prior failed shoulder surgery. Traditional total shoulder replacement would still leave these individuals with pain and the inability to lift their arms above their shoulders. In a reverse total shoulder replacement surgery, the ball and the socket are switched. The metal ball is attached to the scapula, and the socket is attached to the end of the humerus. This allows the deltoid muscles, instead of the damaged rotator cuff muscles, to lift the arm above the shoulder.

Following your reverse shoulder replacement, your doctor will provide you with pain medication and antibiotics to minimize your pain and reduce your risk of infection. Most patients are able to get out of bed and move around the day following their surgery and are able to return home only a couple days later. 

After your surgery, you will need to keep your arm in a sling for a few days. As for rehabilitation, we will provide you with several exercises that can help increase your endurance and mobility and speed up the recovery process. Physical therapy will also likely be required as part of your recovery regimen. 

You should be able to return to normal everyday activities like grooming and dressing yourself a few weeks after the procedure. Your doctor will schedule a follow-up appointment to ensure your shoulder is healing correctly.

You will notice an immediate change in the movement of your shoulder following replacement surgery. It will move more freely and smoothly. However, in the weeks following the surgery, you may experience serious pain and discomfort. After about two weeks, the pain should begin steadily decreasing.

It is important to be cautious during this time. Don’t rush to get back to the regular swing of things. You may need to alter your routine to accommodate your healing shoulder. Avoid picking up heavy objects or positioning your arm in an unnatural way. For the majority of your recovery, your arm will remain inside the sling and you shouldn’t attempt to do anything that requires taking your arm out of it. 

It may be anywhere between four to six weeks before you can pick up objects heavier than a glass of water or get behind the wheel of a vehicle. In the meantime, you should complete physical therapy and at-home exercises to ensure your shoulder heals quickly and correctly.