Shoulder replacement surgery is a procedure designed to relieve pain and restore function in a severely damaged or arthritic shoulder joint. This procedure involves removing the damaged portions of the shoulder joint and replacing it them with an artificial joint made from advanced materials like metal alloys and polyethylene (plastic).
Types of Shoulder Replacement
Total shoulder replacement or arthroplasty (TSA)
Reverse shoulder replacement or arthroplasty (RSA)
Partial shoulder replacement (Shoulder hemiarthroplasty)
Why Consider Shoulder Replacement?
Advanced Arthritis: For those with advanced arthritis of the shoulder due to osteoarthritis or rheumatoid arthritis, a total shoulder replacement (TSA) surgery offers a long-term solution to manage symptoms and improve function.
Rotator cuff arthropathy: This is severe arthritis developing in a shoulder with a massive irreparable rotator cuff tear. For such patients a reverse shoulder replacement (RSA) offers the best chance to relieve their pain and regain shoulder function.
Complex fractures of the shoulder: Some patients with a complex fractures involving the shoulder joint (a severe 4-part proximal humerus fracture) may be suitable candidates for a either total shoulder replacement (TSA), reverse shoulder replacement (RSA) or a partial shoulder replacement (hemiarthroplasty) depending upon the type of fracture, age of the patient, status of the rotator cuff and the functional needs of the patient.
What is the difference between a Total shoulder replacement (TSA), Reverse shoulder replacement (RSA) and Partial shoulder replacement (Shoulder hemiarthroplasty)?
The normal shoulder joint is a complex structure consisting up of 4 articulations made up of bones which are held together with a capsule and ligaments, and surrounded by muscles and tendons. The main articulation of the shoulder (called the gleno-humeral joint) is made up of the convex humeral head (the ball), and the concave glenoid surface (the socket).
In a Total shoulder replacement (TSA), the humeral head is replaced with a metallic ball and the glenoid surface is replaced with a polyethylene (plastic) socket which articulate together to replicate the function of the shoulder.
In a Reverse shoulder replacement (RSA), this arrangement is reversed – the humeral head is replaced with a metal-backed plastic socket and the glenoid surface is replaced with a metallic ball.
In a Shoulder hemi-arthroplasty, only the humeral head is replaced with a metallic ball, which articulates with the patient’s native glenoid socket.
Benefits of Reverse Total Shoulder Replacement
Enhanced Pain Relief: Significant reduction in shoulder pain.
Improved Functionality: Better range of motion and improved ability to perform daily activities.
Increased Stability: Enhanced shoulder stability and function, especially in patients with damaged rotator cuffs.
Choosing between a Total shoulder replacement (TSA), Reverse shoulder replacement (RSA) and Partial shoulder replacement (Shoulder hemiarthroplasty)
Choosing the best possible treatment option for a patient involves careful consideration of the patient’s age, expected function and a careful evaluation of the Xrays, CT scans and MRI scans. Dr.Korday, based on his experience and expertise in treating patients with shoulder problems will help you choose the best option to achieve optimum shoulder function.