Mr Simon Lambert BSc FRCS FRCSEdOrth

Consultant Orthopaedic Shoulder & Elbow Surgeon

Total shoulder replacement

When the joint surfaces have become so damaged as to be deformed and the function of the joint has become markedly limited so that night pain and poor daily function is a problem, then joint replacement is very valuable.

Nowadays joint replacements are very reliable, and replicate the anatomy of the joints rather well, so they can restore function well. If the rotator cuff (RC) is intact and working well then the function of a shoulder replacement can be almost as good as that of a normal healthy shoulder joint.

If the RC is not intact or working inadequately then the type of shoulder replacement can be changed. In these cases although pain relief is still very good the overall shoulder function can be more limited, although nearly always better than before the procedure.

In both types of replacement physiotherapy is very important for the best recovery. Shoulder replacements start to work well by about three months after the operation, but can go on improving over a two-year period as the muscles strengthen and stamina is restored. The risk of revision is nowadays low, being about 3% in this practice.

Adaptable total shoulder replacement

The anatomic, adaptable total shoulder replacement (Epoca, DePuy-Synthes) used by Mr Lambert for “simple” osteoarthritis of the shoulder when the muscles of the shoulder (the rotator cuff) are intact and working well. 

Fixed-fulcrum total shoulder replacement 

The fixed-fulcrum total shoulder replacement (Bayley-Walker, Stanmore Implants) is used by Mr Lambert for 'complex' arthritis of the shoulder when the muscles of the shoulder (the rotator cuff) are not intact and/or not working well.

Customised total shoulder replacement

When the glenoid bone quality is insufficient to hold a Bayley-Walker fixed-fulcrum total shoulder replacement, and the rotator cuff is insufficient as well, then the customised total shoulder replacement from Stanmore Implants can be very helpful in the relief of pain and restoration of personal dignity, eg for hygiene.

(Images: Mr Simon Lambert)