Shoulder Joint Replacement in the Portland area
Arthritis of the shoulder joint can cause severe pain, stiffness, and generally limit the usefulness of your arm. Most physicians will agree that the most effective treatment for end stage arthritis of the shoulder is a shoulder replacement surgery. Shoulder joint replacement, also called total shoulder arthroplasty, has been performed since the 1950s and has improved considerably over the years. This surgery offers a safe and effective way to relieve shoulder pain and restore lost function related to arthritis of the shoulder joint.
How Does Your Shoulder Work?
To better understand shoulder joint replacement, it helps to know about the parts that make it function. The shoulder has a greater range of motion than any other joint in the body because it is comprised of two joints: one to connect the shoulder blade to the collarbone and a ball and socket joint to connect the upper arm to the shoulder blade.
There is tremendous freedom of motion across the shoulder ball and socket joint. The joint portion of theses bones are covered in a special cartilage that allows for smooth gliding and shock absorption across the joint. The four muscles and tendons of the rotator cuff connect the upper arm bone to the shoulder blade and assist in producing motion at this joint. A tissue called the synovial membrane, which lubricates the cartilage and reduces friction, lines the rest of the joint.
What is Causing Your Pain?
Over time, wear and tear can lead to loss of the cartilage covering on the bones. This will cause pain and stiffness that may interfere with your ability to participate in activities you love, such as fishing, canoeing or swimming. Joint replacement can fix this, but the type of shoulder replacement will depend on the cause of your pain.
Osteoarthritis (Degenerative Joint Disease)
This type of arthritis typically occurs in those over 50, but can occur in younger people too. Over time, the cartilage that protects your shoulder bones wears down, causing stiffness and pain as the bones rub directly against one another. Think of it as an unoiled bike: with frequent use, friction will wear down the parts, making rides less smooth, and eventually causing the need for new parts. Unfortunately, although you can protect your bike parts with a little oil, there is no way to prevent osteoarthritis.
This type of arthritis occurs when the synovial membrane thickens and becomes inflamed. It can eventually cause cartilage loss and eventually bone-on-bone arthritis with shoulder pain and stiffness.
This can develop following shoulder injury, such as severe humeral fractures or recurring shoulder dislocations. As with other types of arthritis, ultimately the protective joint cartilage is lost leaving the bones to rub directly against one another.
Rotator Cuff Tear Arthropathy
This type of arthritis develops after years of living with a large rotator cuff tear in your shoulder. When a large portion of the rotator cuff is torn, the ball does not stay perfectly situated in the socket, leading to abnormal shearing forces in the joint that cause a gradual loss of the protective joint cartilage and eventual arthritis.
Is Surgery Right for You?
If severe shoulder pain is interfering with your daily life and forcing you to give up your favorite activities, you might consult with an orthopedic surgeon to see if you would benefit from a shoulder joint replacement. The orthopedic surgeon will evaluate you to determine whether surgery is an option and which type is the best for you.
Total and Partial Shoulder Replacement
A total shoulder replacement includes replacing both the ball and socket of the shoulder with prosthetics. The prosthetic ball is made of metal and the socket is plastic. Your doctor would perform a partial replacement when problems are isolated to the ball, only replacing the ball with the metal prosthesis. Partial or total replacements are effective for patients with shoulder arthritis with a normal or no tears in the rotator cuff.
Reverse Total Shoulder Replacement
Your surgeon would attach the ball-shaped prosthesis to the socket, then attach the plastic cup to the upper end of the arm bone. This shoulder arthroplasty is best suited for those with arthritis and an irreparable rotator cuff tear. Reversing the placement of the ball and cup allows the other surrounding muscles to better support the joint and make up for the lost rotator cuff muscles.
Post-surgery, be sure to follow all of your doctor's instructions to help minimize complications and maximize the benefits of the surgery. Although you might be tempted to get back in the game right away, rest is very important to recovery. In the long run it will all be worth it when you are able to get back into the lifestyle you enjoy, pain-free.
A Higher Standard of Orthopedic Care: Dr. David P. Huberty
Dr. Huberty is committed to providing compassionate orthopedic care using up to date techniques, specializing in shoulder surgery as well as keeping an active sports medicine, elbow and hand surgery practice. To schedule an appointment, contact either his Oregon City, OR or Tualatin, OR practice at (503) 656-0836.