The shoulder is a ball and socket joint. The ball portion of the joint is called the humeral head, and is part of the humerus (upper arm bone). The socket portion is called the glenoid, and is part of the scapula (shoulder blade). The humeral head (ball) fits into the glenoid (socket) and the two bones rub together as the shoulder moves.

In a healthy shoulder joint, the surfaces of these bones where the ball and socket rub together are very smooth and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage. These damaged surfaces eventually become painful as they rub together.

There are many ways to treat the pain caused by arthritis. One way is total shoulder replacement surgery. The decision to have total shoulder replacement surgery should be made very carefully after consulting your doctor and learning as much as you can about the shoulder joint, arthritis, and the surgery. In total shoulder replacement surgery, the ball and socket that have been damaged by arthritis are removed and replaced with artificial parts made of metal and a very durable plastic material. We call these artificial parts "implants." These implants are shaped so that the shoulder joint will move in a way that is very similar to the way the joint moved when it was healthy.

This procedure usually involves an anaesthetic my anaesthetist is an expert in regional blocks and you can have a choice of being awake while the surgery is done.

The patient is first taken into the operating room and positioned on a special operating table as though lounging in a beach chair. The arm is placed on a board that will allow the surgeon to move it up or down as necessary during the surgery. Anesthesia is given and, when it has taken effect, the skin around the shoulder and upper arm is thoroughly scrubbed and sterilized with an antiseptic liquid.

An incision about six inches long is then made over the shoulder joint. The incision is gradually made deeper through muscle and other tissue until the bones of the shoulder joint are exposed.

Successful joint replacement surgery may relieve your pain and stiffness, and may allow you to resume some of your normal daily activities as instructed by your doctor. But even after you have fully recovered from your surgery, you may still have some restrictions. Normal daily activities for shoulder replacement patients do not include contact sports "jamming" activities such as hammering, repetitive heavy lifting, or activities that put excessive strain on your shoulder. Although your artificial joint can be replaced, a second implant is seldom as successful as the first.

Talk with your doctor about the following points, and how they might affect the longevity and success of your shoulder replacement:

  • Avoiding repetitive heavy lifting

  • Avoiding "jamming" activities such as hammering

  • Staying healthy and active

  • Avoiding "impact loading" sports such as boxing

  • Consulting your surgeon before beginning any new sport or activity, to discuss what type and intensity of sport or activity is appropriate for you

  • Thinking before you move

  • Not lifting or pushing heavy objects.

The shoulder joint is then replaced depending what the pathology is it can be a Stemless or stemmed depending om quality of bone

 It can be Anatomical or reverse depending on cuff anatomy.I use the Depuy Global AP system.

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