Surgery for arthritis is known as shoulder arthroplasty (replacement) surgery.
Surgery is required for patients who have already tried non-surgical measures without success and with late stages of arthritis.
Surgery is performed under general anaesthesia. An additional nerve block may be used to numb the arm for 6-12 hours after surgery.
A 7-10 cm incision is made at the front of the shoulder. The surgery takes approx. 1.5-2hrs.
There are three different types of shoulder replacement surgery; Hemiarthroplasty, Total Shoulder Replacement and Reverse Shoulder Replacement.
This involves replacement of the humeral head alone. The indications are limited and the surgery is primarily confined to young patients with disease in the humeral head such as in Avascular Necrosis.
Total shoulder replacement (arthroplasty)
Total shoulder replacement involves replacement of the glenoid and humeral components with a prosthesis.
There have been numerous advances in total shoulder in material design and surgical technique. These theoretically provide greater accuracy and potentially improved longevity.
Dr Baba utilises Patient specific instrumentation, including preoperative templating software and patient specific guides to improve surgical accuracy in complex cases.
Dr Baba utilizes stemless humeral implants. These are smaller and preserve bone and reduce the risk of humeral shaft fractures during implantation.
Shoulder replacement routinely improves pain and function in the treatment of shoulder arthritis. Survival rates are close to 90-95% at 15years.
Reverse shoulder replacement (arthroplasty)
This is used in patients with cuff tear arthritis. Here, a metal ball replaces the glenoid and the socket is on the humeral stem.
The replacement reliably improves shoulder pain and function. 10-year survival rates approximate 90%.
- Patients stay in hospital for 1 night.
- Most patients are in a sling for 2-6 weeks.
- Patients gradually return to physical activities at 6 weeks post op.
- At one year, the majority of patients have pain free function.
Risks and complications
- Fractures (during or after surgery).
- Excess Bleeding.
- Nerve injury.