07 November 2017
Helen Culling of Spire Norwich Hospital discusses why shoulder replacement surgery is on the increase with Consultant Orthopaedic Surgeon Mr Emmet Griffiths.
Shoulder joint replacement was first carried out in the United States back in the 1950s but has never been as common as hip or knee replacements.
However, in the past few years techniques and outcomes have improved and the procedure is becoming much more common.
Consultant Orthopaedic Surgeon Mr Emmet Griffiths explains what shoulder replacement surgery involves and how it has developed in recent years.
Q: What is a shoulder replacement?
A: The shoulder is a ‘ball and socket’ joint like the hip joint– the ‘ball’ at the end of your upper arm bone fitting into a ‘socket’ in the shoulder blade. Unlike the hip however the ‘ball’ of the shoulder sits on the socket rather than in it. This is similar to a golf ball resting on a golf tee. A replacement means a metal ball is fitted to your upper arm and a plastic cup-like device inside the socket. This is called an anatomic shoulder replacement because it reproduces the normal shoulder anatomy but it does rely on having intact tendons around the shoulder to move the joint.
Q: Why has it taken so long for shoulder replacements to become a bigger part of orthopaedic surgery?
A: Osteoarthritis of the shoulder is far less common than in the hip or the knee as it is not a weight bearing joint. Over the last twenty years we have a better understanding of shoulder disease and pathology and this has led more successful shoulder replacement surgery that we can therefore offer to more patients.
Q: How have the surgery techniques and equipment progressed over the past ten years?
A: Techniques and instruments have improved to provide better exposure of the socket for accurate placement of the prosthesis. The designs of the implants have improved to reflect patients’ variable anatomy.
Q: What would make you consider a shoulder replacement?
A: One of the most common reasons why people need shoulder replacement surgery is arthritis. This causes pain and reduced range of movement in the shoulder, the main indication for surgery is pain. Occasionally however a traumatic injury such as a fracture of the shoulder joint may require a shoulder replacement.
Q: What is a Reverse Shoulder Replacement?
A: Standard shoulder replacement is an anatomic shoulder replacement as mentioned above. A reverse shoulder replacement puts the ball where the socket should be and the socket where the ball should be. This allows the shoulder joint to be moved by a single muscle the deltoid muscle and therefore compensates for the loss of function resulting from torn tendons around the shoulder (the rotator cuff). It may be used for patients who have a painful shoulder and limited movement due to badly torn rotator cuff tendons or an arthritic shoulder with torn tendons.
Q: Is there a ‘typical’ age of a patient needing a replacement or is it something that covers all age groups?
A: The common age group of patients who have shoulder replacements are mid-sixties to mid-seventies. However there are patients in all age groups who may benefit from shoulder replacement when other treatment options have failed.
Q: What is the expected recovery after surgery?
A: Most patients stay in hospital for just a single night. A simple sling is likely to be necessary for 4-6 weeks after surgery. Physiotherapy is normally required for several months. Patients should expect to be back driving at around 6 weeks.
Q: What sort of results can patients expect after surgery?
A: Most patients can expect excellent pain relief and improved range of movement of their shoulder. Some patients may achieve almost full movement but the final movement also depends on the range of movement patients have prior to surgery. Anatomic shoulder replacements tend to give better range of movement than reversed polarity replacements.
Q: How long would you expect a shoulder replacement to last – is it on a par with hip or knee replacements?
A: Most studies record 90 to 95% of shoulder replacements lasting 10 years so they are approaching the same outcomes as hip and knee replacements. It is possible to revise failing shoulder replacements but this may be technically challenging.
For further information or to make a private appointment please contact one of the team on 01603 255 614. Further details regarding consultant Orthopaedic surgeon Mr Emmet Griffiths can be found on his consultant profile at www.spirenorwich.com.
All surgery carries an element of risk and the content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.