Our Summary

The number of people getting shoulder replacement surgeries is growing each year, with over 6,500 recorded in 2017. Most of these surgeries are not emergencies, but are chosen by the patient. Recently, there’s been some debate about which kind of shoulder replacement is best for different groups of patients.

For patients who have shoulder issues after breaking the top part of their upper arm bone, doctors can’t agree on which surgery is best. Data shows that more and more people are choosing a specific type of surgery known as ‘reverse total shoulder replacement’ over other options.

This paper is looking at all the published research on the different types of shoulder replacements for patients who have previously broken their upper arm bone, in the hope of helping UK shoulder surgeons decide on the best approach.

FAQs

  1. What has been the trend in the number of people getting shoulder replacement surgeries?
  2. What is the ‘reverse total shoulder replacement’ surgery?
  3. What is the purpose of the research being done on different types of shoulder replacements?

Doctor’s Tip

One helpful tip a doctor might tell a patient about shoulder replacement is to carefully consider the type of surgery that is best for their specific situation. It’s important to discuss the pros and cons of different options with your surgeon and make an informed decision based on your individual needs and goals. Additionally, following your surgeon’s post-operative instructions and participating in physical therapy as recommended can greatly improve your recovery and long-term outcome.

Suitable For

Typically, patients who are recommended for shoulder replacement surgery are those who have severe shoulder pain, limited range of motion, and functional impairment that has not improved with conservative treatment options such as physical therapy, medications, and injections.

Specifically, patients who may benefit from shoulder replacement surgery include those with osteoarthritis, rheumatoid arthritis, avascular necrosis, severe fractures, rotator cuff tears with arthritis, and failed previous shoulder surgeries.

Patients who have previously broken the top part of their upper arm bone may also be recommended for shoulder replacement surgery, especially if they are experiencing persistent pain, weakness, and limited function in the shoulder joint. In such cases, the decision on which type of shoulder replacement surgery to undergo will depend on the individual patient’s specific condition and needs, as well as the recommendations of their healthcare provider.

Timeline

Before shoulder replacement surgery, a patient may have been experiencing severe shoulder pain, limited range of motion, stiffness, weakness, and difficulty performing daily activities. They may have tried conservative treatments such as physical therapy, medications, injections, and lifestyle modifications with little to no improvement.

After deciding to undergo shoulder replacement surgery, the patient will undergo a thorough pre-operative evaluation, including imaging tests such as X-rays and MRI scans. They will also meet with their surgical team to discuss the procedure, risks, benefits, and recovery process.

During the surgery, the damaged parts of the shoulder joint are removed and replaced with artificial components made of metal, plastic, or ceramic. The type of shoulder replacement surgery (traditional total shoulder replacement, reverse total shoulder replacement, or partial shoulder replacement) will depend on the patient’s specific condition and needs.

After the surgery, the patient will stay in the hospital for a few days for monitoring and rehabilitation. Physical therapy will be an important part of the recovery process to regain strength, flexibility, and function in the shoulder. Pain management and follow-up appointments with the surgical team will also be part of the post-operative care plan.

Overall, the goal of shoulder replacement surgery is to relieve pain, improve function, and enhance quality of life for patients with shoulder joint problems. With proper care and rehabilitation, many patients are able to return to their normal activities and enjoy a better quality of life after shoulder replacement surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about shoulder replacement surgery include:

  1. What type of shoulder replacement surgery do you recommend for me, given my specific condition and medical history?
  2. What are the potential risks and complications associated with the recommended surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. What are the potential long-term outcomes and success rates of the recommended surgery?
  5. Are there any alternative treatments or therapies that I should consider before opting for shoulder replacement surgery?
  6. How many shoulder replacement surgeries have you performed, and what is your success rate?
  7. What post-operative care and follow-up appointments will be necessary?
  8. Will I need physical therapy after the surgery, and if so, for how long?
  9. What restrictions or limitations should I expect after the surgery in terms of physical activity?
  10. Are there any specific lifestyle changes or precautions I should take to ensure the best possible outcome after the surgery?

Reference

Authors: National Guideline Centre (UK). Journal: London: National Institute for Health and Care Excellence (NICE); 2020 Jun. PMID: 32881457