Shoulder replacement surgery is an operation that replaces the worn articular surfaces of the humeral head and glenoid that make up the shoulder joint. This operation is done for a variety of reasons and in a number of different ways. The most common reasons for having a shoulder joint replacement are osteoarthritis, rotator cuff arthropathy, rheumatoid or other inflammatory arthritis, avascular necrosis, and a fractured proximal humerus that is unreconstructable. Traditional “anatomic” total shoulder replacement (TSR) and resurfacing operations rely on functioning rotator cuff muscles (subscapularis, supraspinatus, infraspinatus and teres minor) to provide stability and function to the replaced shoulder joint. When these muscles are unable to be relied upon for this function, such as in the setting of rotator cuff arthropathy where large unrepairable rotator cuff tears are present, a reverse prosthesis is indicated. In a reverse TSR, the ball (glenosphere) is placed onto the glenoid (scapula) instead of the humerus, reversing the usual articulation. This allows the large deltoid muscle to more effectively function as a prime mover of the shoulder joint without the need of a functional rotator cuff. Recent advances in technology including computer navigation and patient specific instrumentation, when appropriately indicated have allowed more precise implantation of components, particularly the glenoid component. Dr Rae works closely with his anaesthetic team to provide the best possible pain relief after your operation. This will commonly involve regional anaesthetic blocks and a combination of analgesics (pain killers) to make your hospital stay and first few weeks at home as pleasant as possible.
Following shoulder joint replacement you are normally placed in a sling for between 4 and 6 weeks. You will have a personalized physiotherapy program given to you with specific rehabilitation instructions for you and your physiotherapist to work with. If you do not have a physiotherapist, Dr Rae is happy to recommend one to you. When appropriately indicated and performed, shoulder joint replacement of whichever form, provides reliable and effective pain control and a significant increase in premorbid function with high rates of patient satisfaction. Patients will see the full benefit over a period of 3-6 months post operatively, and may continue to improve over the 12 months after that.
This is general information only and if you would like to talk to Dr Hamish Rae more about your shoulder pain and options for treatment please call 80055111 to make an appointment.