Total Shoulder Replacement Surgery Procedure

The goal of total shoulder replacement surgery is to get rid of shoulder pain and increase shoulder function by reappearing the bones that meet at the shoulder's ball-and-socket joint, or glenohumeral joint. The shoulder surgeon removes the humeral head at the top of the arm bone (humerus), reshapes the shoulder socket (glenoid), and attaches prosthetic modules to both bones.

What Is Shoulder Arthritis?

Shoulder arthritis is a condition in which degeneration, damage, inflammation or previous surgery destroys the usually smooth cartilage on the ball (humeral head) and socket (glenoid).

Total Shoulder Replacement Step-by-Step Explanation

Surgical procedures can differ depending on the patient's requirements and the shoulder surgeon's preferences, but normally the steps of Total Shoulder Replacement Surgery are as follows:

• The patient's blood pressure, heart rate, body heat, and oxygenation levels are checked beforehand surgery can progress. A mark is made on the shoulder undergoing operation before the patients goes into the operational room to make sure that the correct shoulder is being operated on.
• Anesthesia is controlled. Usually, a patient receives local anesthesia (is put to sleep). On the other hand, some patients are given an additional regional anesthesia to block sensation in the arm and around the shoulder. The type of anesthesia a patient will receive is decided well ahead of the surgery.
• The physician makes an incision approximately 5 inches long, starting at the top and front of the shoulder and bent along the deltoid muscle. The shoulder surgeon then cuts through deeper tissue, including one of the shoulder rotator cuff tendons to pass in the shoulder joint.
• The top of the upper arm bone, called as the humeral head, is dislocated from the socket of the scapula, or glenoid.
• The shoulder surgeon will study the humeral neck, which is the region just under the rounded head of the humerus. The surgeon uses an instrument called an osteotome to eliminate any bone spurs that may have advanced on the humeral neck as the result of arthritis.
• The physician uses a bone saw to eliminate the humeral head.
• The shoulder surgeon prepares the humerus bone for the prosthetic humeral stem. The humeral stem is a slender, tapered metal shaft that fits numerous inches down inside the humerus. The top of this stem is intended to hold a prosthetic ball that will substitute the natural humeral head.
• The physician uses a special instrument called a reamer to even out and shape the shoulder socket (glenoid) and arrange it for its prosthesis.
• The synthetic socket, or glenoid prosthesis, is generally made of polyethelyne and has a smooth, to some extent concave design to facilitate movement with the prosthetic humeral head. A new socket is generally backed by either a few short pegs or a flat, straight edge called a keel (which is shaped like the keel of a boat). The pegs or keel fits into the natural bone.
• The prosthetics may be followed to the natural bone with bone cement or they may be cement less (sometimes called "press fit") components. The fast-acting bone cement takes only about 10 minutes to set.