Shoulder Replacement Surgery
Arthritis of the shoulder is a loss of cartilage on the articular surface of the joint. When symptoms impair the function of the shoulder significantly and conservative treatments have failed, total shoulder arthroplasty replacement is a proven technique for treatment. Although arthroscopic treatment options exist, they are not always appropriate for all patients and anatomic shoulder replacement is recommended. Dr Lenarz has advanced fellowship training in the treatment of shoulder arthritis and he ensures that the appropriate procedure is selected and done with the necessary surgical expertise and experience. Treatment of shoulder and elbow problems remains the focus of Dr. Lenarz’s practice to make certain his patient’s are expertly treated with contemporary surgical techniques that optimize the outcome.
Shoulder implants have also been evolving in shoulder surgery. Recent developments have included a “stemless” shoulder implant. The use of this implant minimizes the amount of bone that is removed from the humerus (ball side of the joint) during the procedure. This becomes important in that it decreases the amount of tissue removed and likely the amount of bleeding and pain. In addition, if the shoulder replacement were ever to fail, it allows for an easier revision of the shoulder, as these implants are easier to remove and there is less bone loss in doing so.
Shoulder implants also include a reverse total shoulder arthroplasty. This is a specialized implant that was developed initially in the 1980’s in France. The design of this implant is such that the “ball” of the joint is placed on the cup side and the “cup” of the joint is placed on the ball side. Thus, it is called a reverse shoulder arthroplasty. Initial indication for a reverse shoulder arthroplasty was primarily for shoulder arthritis with a poorly functioning or torn rotator cuff. When this occurs the rotator cuff cannot be adequately repaired and a standard total shoulder replacement will often fail in a short period of time. Indications for the use of reverse shoulder replacements have expanded to include revision shoulder replacements, comminuted proximal humerus fractures in the appropriate patient and large irreparable rotator cuff tears without arthritis in the appropriate patient. Just like standard total shoulder replacement, reverse shoulder replacement requires expertise in the use and indications for the surgery to ensure an optimal outcome for the patient and their shoulder. Dr. Lenarz offers this expertise.
Shoulder replacement can be done at the hospital or at a surgery center. This procedure usually requires an overnight stay.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Icing the shoulder should be done liberally. This can be through the use of ice in a bag, ice packs or a circulating ice water cooler. The dressing should not be removed and the patient may shower the day following surgery. The patient is asked to NOT scrub the incision but allow water to wash over the dressing.