Total Shoulder Arthroplasty
Orthopaedic Faculty with this Specialization
Robert T. Burks, M.D.
Patrick Greis, MD
Robert Tashjian, MD
University Orthopaedic Resources:
Frequently Asked Questions (FAQ)
Q) What is Total Shoulder Arthroplasty?
A) The basic procedure is to remove the ball of the shoulder and place a metal stem that goes into the humerus or arm bone and then add a metal ball that is of approximately the same size as the one that was removed. On the socket side, a plastic piece is cemented into the socket to return this to a smooth surface. The procedure takes about 21¿2 hours. The motion is started very early after the surgery and emphasized since a major goal of shoulder arthroplasty is to return as much range of motion as possible. The standard time in the hospital is 1 to 2 nights.
Q) What about anesthesia?
A) One of the truly unique features of shoulder arthroplasty at the University of Utah Orthopaedic Center is the use of a small catheter that is placed near the nerves in the neck. We have a unique system for placing these so it is done with a high level of accuracy and with minimal discomfort for the patient. These are connected to anesthesia that runs in slowly over a couple of days. Therefore, it is very common for arthroplasty patients to have virtually no pain over their first couple of days after surgery. This allows patients to get off to a very good start, to not be sick from having to take other medicines, to be able to eat well, and overall be very mobile.
Q) What about complications?
A) There are complications that can occur with this procedure as with many other similar magnitude surgeries. Infection can occur, but you are given preoperative antibiotics to try to minimize this potential. Blood loss is a potential, but transfusion for blood loss is very rare. Nerve injury can occur, but is usually temporary, although a permanent neurologic injury is possible but rare. The components that are placed can loosen over time and need to be revised or removed. The shoulder could dislocate and require some type of reduction or repair. It is possible to fracture around the implants as well. There are other complications inherent to this type of surgery so this is not an exhaustive list.
Q) What about therapy and return to activities?
A) After arthroplasty we try to start physical therapy early and emphasize range of motion. We feel that the patient and his or her family needs to be primarily involved with this and don't rely exclusively on formal physical therapy. Depending on where patient lives we try to make this as convenient as possible and give the patients instruction sheets on how to obtain motion and use of their shoulder. The tendons are usually healed by 6 weeks and normal daily use of the shoulder can be accomplished by this point. It is hoped that there would be full recovery by 6 months which allows return to most all normal activity.
Q) What are the limitations?
A) Because this is an artificial joint it is discouraged to do heavy lifting type work with the shoulder. It is suggested that significant overhead work may be difficult. Routine daily activity, golf, swimming, bicycling, etc. are certainly normal expectations after this procedure. It is expected at this point that approximately 85% of the shoulders placed are still functioning well at 10 years.
The information provided may be useful for patients to become more knowledgeable about their specific injury, surgery or condition. It is provided for informational purposes only, and does not replace the advice of a physician.
