Dr. Joe Cooper is a fellowship-trained orthopedic surgeon and sports medicine expert who specializes in conditions of the shoulder, knee, elbow and hip. His office is located in Los Angeles, California. Trained by the best orthopedic surgeons and sports medicine doctors in America, Dr. Cooper is committed to his patients and providing the most advanced medical and surgical treatments available. He is an athlete and team physician for the U.S. Ski and Snowboarding teams. Here he answers your questions about shoulder replacement surgery and more.
The most common reason people end up deciding to have a shoulder replacement is due to pain, especially pain at night that keeps them from sleep. There are two kinds of shoulder replacements, the first is called an anatomic replacement, and the second is called a reverse shoulder replacement. Which one you is best for you is based on the quality of your rotator cuff. Many times, if you cannot lift your arm, it means your rotator cuff is not working and a reverse shoulder replacement may be the best answer for you.
A shoulder resurfacing is very similar to an anatomic shoulder replacement except it requires removing less bone. The ball side of the joint is replaced with a metal cap, and the socket side of the joint is replaced with a small plastic insert. The is a good option for young active patients who want to preserve as much normal bone as possible but still have severe and painful shoulder arthritis.
While the answer to this question is yes you can have another shoulder replacement, the specifics are much more complicated and are based on your specific problem and your history. Many times a second shoulder replacement has additional steps to the procedure such as bone grafting and requires more complex techniques to restore your shoulder. Often a reverse shoulder arthroplasty is a better option when a second replacement is required.
A reverse shoulder arthroplasty is used when your rotator cuff is torn or not working. The rotator cuff functions to balance the ball of the shoulder in the socket. However, when it is torn, it cannot do this, and therefore the replacement requires a different design to ensure it is stable and functions appropriately. In a Reverse Shoulder Replacement, instead of the usual orientation of replacing the ball part of the joint with a ball and the socket part with a socket, we reverse it so that the ball is on the socket side and the socket is on the ball side. This provides more constraint or support of the joint and allows stable motion even if there is no rotator cuff.
Yes the majority of shoulder placements are done on an outpatient basis through the hospital or the surgery center. This means you have the surgery and would go home the same day. Patients who qualify for this are healthy without many additional medical problems such as heart disease, lung disease, or diabetes. If you have some of those other medical issues your surgery is commonly done in the hospital and you may stay one or two nights as needed.
Shoulder replacement recovery is guided by your physical therapist. It consists of 4 weeks in a sling working on range of motion, followed by progressive stretching and strengthening. Generally, people are able to return to all activities such as golf or tennis by about 4-5 months.
I do not place any restrictions on activity after shoulder replacement. Reverse shoulder replacement can lead to limitations in some range of motion. Most notably internal rotation.
The CAM procedure is meant for young people in their 20s and 30s who have severe pain and limited motion from arthritis but are not ready for a shoulder replacement. It involves reshaping the bones of the shoulder arthroscopically, cleaning the joint, releasing the nerve of the shoulder to give it more space, and smoothing the remaining cartilage as much as possible. It is not meant to replace the missing cartilage or restore the shoulder to its exact state from before the arthritis set in, but instead to improve the function and pain as much as possible to avoid shoulder replacement for another 10-15 years.
