Charles Hope, MD: HIP Replacement
The shoulder joint is primarily made up of two bones. These bones are the humerus and the scapula. The scapula is best known as the shoulder blade. The part of the scapula that articulates with the shoulder is called the glenoid. The glenoid meets the head of the humerus to form a ball-and-socket joint. This joint is stabilized by a ring of cartilage called the labrum.
The joint cavity is further cushioned by articular cartilage covering the head of the humerus and the face of the glenoid. The scapula extends up and around the joint to form the acromion, and extends around the joint at the front to form the coracoid process.
Ligaments are bands of tough connective tissue. In the shoulder, ligaments connect the scapula and the humerus. Tendons join the bones to the surrounding muscles. The biceps tendon attaches the biceps muscle to the shoulder and also helps to stabilize the joint.
Shoulder replacement will replace the bones of the joint with artificial prostheses. This procedure is typically done when a patient experiences severe pain in the shoulder joint, limiting movement and disrupting the daily routine. Typically the surgery will take between 1 and 3 hours. The initial incision will be over the shoulder joint. The surgeon will remove the head (top) of the humerus, replacing it with an artificial stem with a rounded metal head. The rounded head will articulate with the new artificial socket, which is a smooth plastic shell. The new shoulder joint will be secured and the incision will be closed with stitches or staples. The surgeon will finish by dressing the wound appropriately. Drains may be placed in the wound to assist with proper draining of fluid build-up. These will be removed by a healthcare provider when they are no longer needed.
If the patient has a torn rotator cuff and shoulder arthritis, they may be candidates for a reverse shoulder replacement. The incision will be the same as the regular shoulder replacement. The major difference between the two types of shoulder replacement is the location of the new metal round head. In a total shoulder, the artificial round head is positioned on the top of the humerus. In a reverse shoulder replacement, the artificial round head is positioned on the side of the glenoid.
After your procedure, you may stay in the hospital for between 1 and 3 days. While in the hospital, a physical therapist will assist you in keeping the muscles from getting stiff. Physical therapy will also help you in regaining strength as well as using your good arm until you are able to completely use your shoulder.
Shoulder replacement surgery typically relieves pain and stiffness. Patients report being able to return to most of their daily activities without incident. The patient’s ability to return to the activities that they enjoy usually depends on the strength of the muscles surrounding the new joint replacement. The stronger patients usually have better outcomes after surgery.