Anatomic Total Shoulder Replacement
Recent advances in total shoulder replacment have significantly improved patient outcomes and as such, total shoulder replacement has increased in popularity in the last decade. In fact, studies have shown that greater than 90% of patients return to a sport after shoulder replacement, and about 90% of paitents are doing well after surgey after 15 years.
Candidates for total shoulder replacment are individuals with moderate to severe shoulder arthritis with an intact rotator cuff and have failed conservative treatement in the form of corticosteroid injections and therapy.
Surgical procedure involves making a 6-inch incision in the front of the shoulder. The subscapularis tendon is detached to open the shoulder like a book. The arthritic head is removed and a new metal stem and ball are placed int the arm. On the socket side, the socket is somoothed and a polytethylene socket is cemented into place.
Stemless Total Shoulder Replacement
Stemless total shoulder replacement is the latest in shoulder replacment technology. Although performed in Europe with good clinical succees for several years, this technology was not released in the United States in 2015. Dr. Ramirez was one of the first surgeons trained in this technology.
Stemless total shoulder was developed as a minimally invasive way to replace the shoulder, specifically in younger patients in which bone preservation is of utmost importance. Because the humeral shaft is not violated, this replacement preserves more of a patient’s normal anatomy than stemmed inplants.
Potential advantages of stemless total shoulder replacement are: 1. More bone preservation, 2. Decreased surgical times and less blood loss, 3. Potentially decreased healing time.
Ideal candidates for this surgery are young osteoarthritics with good bone stock. Ask Dr. Ramirez if you are a candidate for stemless total shoulder replacement.
Recovery After Total Shoulder Replacement
Full recovery after total shoulder replacement is different for every patient. However, most patients are back to most activities 3-4 months after surgery. Recovery after surgery is as follows:
- Most patients leave the hospital the next day after surgery.
- Patients are in a sling for 4-6 weeks.
- Patients are allowed to come out of the sling for waist-level activities (such as writing, typing, eating, etc.) right away as long as they are lifting less than 1 pound.
- Therapy begins at 4 weeks. Most patients will do their own therapy at home without the need of seeing a therapy.
- At 3 months, patients are released to full activity without restrictions.