Shoulder & Elbow

About Shoulder & Elbow

The University of Utah Orthopaedics shoulder and elbow service provides excellent and quality care for problems affecting the shoulder and elbow, including athletic, traumatic, degenerative and specific diagnoses, such as the following:

• Arthritis
• Arthroscopic (minimally-invasive) shoulder procedures
• Dislocation or instability
• Elbow ligament reconstruction
• Fractures
• Joint stiffness or pain
• Rotator cuff disease
• Tendon tears
• Tennis elbow
• Total elbow or shoulder replacement

The shoulder and elbow team creates and utilizes the latest advances in shoulder and elbow diagnosis, treatment and rehabilitation.

Contact Us

(801) 587-7109

Total Shoulder Arthroplasty

• What is total shoulder arthroplasty?
• How does the anesthesia work?
• What are the possible complications?
• What about therapy and return to my normal activities?
• What are the limitations of my new joint?

What is total shoulder arthroplasty?

The basic procedure of total shoulder arthroplasty removes the ball of the shoulder and places a metal stem that goes into the arm bone, or humerus, and then adds a metal ball. On the socket side, a plastic piece is cemented into the socket to return this to a smooth surface. The procedure takes about two hours. Afterward, you are encouraged to move the joint since a major goal of shoulder arthroplasty is to return as much range of motion as possible. The standard time in the hospital is one to two nights.

How does the anesthesia work?

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 (anesthesia). Because we have a unique system for placing these, it is done with minimal discomfort for the patient and a high level of accuracy. These are connected to anesthesia that runs into the area slowly over a couple of days. Because of this it is very common for arthroplasty patients to have minimal to no pain over their first couple of days after surgery. This allows patients to start well after surgery since they are not sick from other medications, can eat well and be very mobile overall.

What are the possible complications?

The complications that can occur with this procedure are similar to other surgeries of this magnitude. They include the following: infection, blood loss, nerve injury, loosening of the replacement parts, dislocation and fractures around the implants among others; however, the specialists at the orthopaedic center give you preoperative antibiotics to counter infection, rarely need to give blood transfusions and find that while nerve injury can occur, it is usually temporary (although, a permanent neurologic injury is possible but rare). Also, the components that are placed in the joint can be revised or removed.

What about therapy and return to my normal activities?

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. However formal physical therapy can be very useful. Depending on where the 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 six weeks and normal daily use of the shoulder is possible by this point. We anticipate a full recovery by six months, which allows return to almost all normal activity.

What are the limitations of my new joint?

Because this is an artificial joint, we discourage heavy lifting-type work with the shoulder. Significant overhead work may be difficult. However, you should be able to perform routine daily activities, like golf, swimming, bicycling. Currently, approximately 85% of the shoulder joints replaced are still functioning well at 10 years.