Shoulder replacement: modern options for patients
Shoulder pain and limited movement can significantly affect daily life. For many patients, shoulder replacement surgery can offer relief and improved function.
In this article, consultant orthopaedic surgeon Mr Peter Reilly explores the modern options for shoulder replacement, including partial, total, and bone-sparing procedures, helping patients understand the choices available.
What is shoulder replacement?
Shoulder replacement surgery involves replacing damaged parts of the shoulder joint with artificial components, known as implants. The aim is to reduce pain, restore movement, and improve quality of life. Surgery is considered when non-surgical treatments such as physiotherapy, medication, or injections have not provided sufficient relief.
Partial shoulder replacement
Partial shoulder replacement, also called hemiarthroplasty, replaces only the ball of the shoulder joint while preserving the natural socket. This option is often suitable for patients with arthritis affecting mainly the humeral head or those who have suffered a fracture.
Benefits include:
- Less invasive than total shoulder replacement.
- Preservation of more natural bone.
- Shorter recovery time.
However, partial replacements may not be suitable if the socket is also damaged or arthritic.
Total shoulder replacement
Total shoulder replacement involves replacing both the ball and the socket of the joint. This option is generally recommended for patients with advanced arthritis affecting the entire joint. Modern implants are designed to mimic natural movement and can provide:
- Significant pain relief.
- Improved joint function.
- Long-term durability.
Reverse shoulder replacement
Reverse shoulder replacement is a type of total shoulder replacement in which the position of the ball and socket is switched. This design allows the deltoid muscle to compensate when the rotator cuff is not functioning.
It was originally developed for arthritis associated with a major rotator cuff tear, but it is now the most commonly used implant.
Benefits include:
- Reliable pain relief.
- Improved shoulder stability.
- Better function when the rotator cuff cannot be repaired.
Although reverse replacement is widely used, it should not be chosen by default. The most suitable implant varies from patient to patient.
Bone-sparing and modern techniques
For younger patients or those concerned about preserving as much natural bone as possible, bone-sparing techniques are increasingly popular. These approaches use smaller implants and careful surgical methods to maintain bone integrity, allowing for easier revision surgery if required in the future.
Choosing the right option
Selecting the most suitable type of shoulder replacement is a patient-specific decision, and your surgeon will take several key factors into account, including:
- Anatomy: the shape and condition of the shoulder joint, including the rotator cuff.
- Activity level: how active you are now and wish to be after surgery.
- Desired goals and expectations: what you hope to achieve in terms of movement, function, and lifestyle.
Other considerations may include age, overall health, and the extent of joint damage seen on imaging.
Recovery and rehabilitation
Post-surgery recovery typically involves a period of immobilisation followed by physiotherapy. Rehabilitation focuses on regaining movement, strength, and function. Most patients can resume light activities within a few months, with full recovery taking six months or more.
Further information on Mr Peter Reilly’s published research in shoulder surgery can be found on his ResearchGate profile, where several of his peer-reviewed studies are available.