The shoulder comprises a number of components that work together, enabling it to rotate and have a greater range of motion than any other joint in the body. Key to these functions is the “ball and socket”, or the head of the humerus/arm bone sitting in the socket of the glenoid and held together by ligaments, tendons, cartilage, and muscles.
If injury or damage occurs to any part of the shoulder joint, pain, stiffness, and inflammation may occur, resulting in numerous shoulder ailments. There are multiple treatment options for shoulder injuries, one of which is a total shoulder arthroplasty.
Total shoulder arthroplasty, also known as total shoulder replacement, is a type of surgery that involves replacing injured or damaged parts of the shoulder with prostheses or artificial components.
A total shoulder arthroplasty is recommended when the shoulder joint or rotator cuff cannot rotate smoothly without stiffness or pain,usually as a result of injury or damage. This surgery is typically recommended when patients have moderate to severe pain and joint stiffness or instability that does not improve after treatment methods such as painkillers, exercises, and other minor surgeries.
Shoulder joint injuries can occur due to falls, accidents, overuse, wear and tear, or repetitive activity. It can also happen due to conditions that weaken the bones and muscles, such as osteoarthritis.
How does total shoulder arthroplasty work?
Total shoulder arthroplasty involves replacing the ball and socket portion in the shoulder with metal and plastic prostheses that are the same shape and size as your shoulder’s anatomy. Typically, the damaged joint is replaced with a metal ball attached to a stem and a plastic socket.
The surgery is done via an arthroscope inserted through small openings in the shoulder. The arthroscope is connected to a video monitor, so that the orthopaedic surgeon can see and perform the procedure without needing to make large incisions.
Total shoulder arthroplasty procedures are done under general anaesthesia, and are often conducted as an outpatient procedure, which may require an overnight stay at the hospital or clinic.
Benefits of total shoulder arthroplasty
Eliminates shoulder pain and stiffness
Improves range of motion and flexibility
Strengthens and stabilises the shoulder joint
Improves quality of life
What conditions can total shoulder arthroplasty treat?
A total shoulder arthroplasty can treat the following conditions:
The results of a total shoulder arthroplasty vary depending on the individual and the condition being treated.
But in general, it will take some time to recover fully from a total shoulder arthroplasty. You may experience swelling and bruising in the shoulder joint and entire arm for the first few days, which is normal. During the first few weeks of recovery, you will be required to attend physiotherapy sessions to strengthen your arm and shoulder.
The exact results of a total shoulder arthroplasty depend on the individual, their medical history, and the complexity of their shoulder injury. However, in general, most patients experience a greater range of motion and significantly less pain and stiffness after recovering fully.
Work closely with your orthopaedist and follow their recommendations for exercises and activities for the best results.
How many treatment sessions are needed?
Only one procedure at a time is typically needed as the entire replacement of the joint is done during the surgery.
However, several physiotherapy sessions and follow-up appointments with your orthopaedist may be required.
Your orthopaedic surgeon will be able to provide you with a bespoke treatment plan, tailored to your needs and requirements.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.