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    Shoulder Replacement Surgery: Definition, Types and Procedure

    shoulder replacement surgery
    (source: orthoinfo)

    Shoulder replacement surgery is performed under the guidance of an expert orthopedic surgeon. It is carried to relieve the pain and symptoms that patients suffer due to damage to the shoulder joint.

    This piece throws light on all the crucial aspects of this surgical procedure to heighten awareness among people seeking necessary treatment.

    What Is Shoulder Replacement Surgery?

    Shoulder replacement is a procedure to eliminate any dysfunctional issue or dislocation resulting in severe pain. In this surgery, the doctor replaces the damaged area of the shoulder joints with artificial elements. These elements are prostheses and the types differ according to the surgery done.

    What Does Shoulder Replacement Surgery Help to Treat?

    The primary purpose of undergoing any type of shoulder replacement procedure is to obtain optimum pain relief. In addition, this procedure helps restore the shoulder's strength and functions.

    The after-effect of this surgery enables patients to perform all activities smoothly, which they were avoiding due to chronic shoulder pain. Other conditions this surgery can treat include:

    • Loss of motion in the shoulder
    • Weakness in the shoulder
    • Disturbed sleep due to pain

    What Are the Different Types of Shoulder Replacement Surgery?

    Orthopedic surgeons on thorough check-ups suggest the type of shoulder replacement surgery that a patient will need. Here are the types of shoulder replacement surgical procedures available in medical science:

    1. Traditional Shoulder Arthroplasty (Total Shoulder Replacement)

    In this surgical procedure, a surgeon replaces the original ball-and-socket area of the shoulder with exact-shaped prosthetics. This shoulder replacement surgery is mostly performed when the patient suffers from paralyzing shoulder arthritis.

    However, one must avoid such procedures who like to stay very active or engage in sports or athletic activities. In addition, people with damaged rotator cuff muscles must take multiple consultations before total shoulder replacement.  

    • Benefits: Beneficial for those who have healthy rotator cuff
    • Survival Rate After Surgery: 10 Years: 97%
    • Cost of Surgery: ₹ 5 lakh approximately

    2. Reverse Total Shoulder Arthroplasty (Reverse Shoulder Replacement)

    This type of shoulder replacement treatment involves completely replacing or reversing the shoulder joint's ball-and-socket position. This means a prosthetic ball is used to fit a natural socket of that shoulder, whereas, a ball on an upper arm bone, called the humerus, goes through a replacement procedure with a socket-shaped prosthetic.

    For patients suffering from damaged rotator cuffs or who are incapable of traditional shoulder replacement surgery, reverse total shoulder arthroplasty is the ultimate option. This surgical treatment offers relief by allowing muscles to function normally even without a rotator cuff.

    Benefits

    • Faster recovery than traditional shoulder replacement
    • It helps in strengthening and stabilising muscles
    • It serves as a option for those that did not benefit from traditional shoulder replacement

    Survival Rate After Surgery

    • 5 Years: 71.6%

    Cost of Surgery:  ₹ 3,24,000 approximately

    3. Stemmed Hemiarthroplasty (Partial Shoulder Replacement)

    A stemmed hemiarthroplasty is a procedure where a doctor removes the entire top part of the arm humeral. The completion of this first step involves the replacement with a prosthetic ball, and a glenoid bone is kept.

    However, a surgeon may reshape this part of the socket to ensure better shoulder joint movement. This process is informally known as “ream and run”.

    Benefits

    • Increases range of motion
    • Decreases swelling and stiffness
    • Reduces pain

    Survival Rate After Surgery

    • 10 Years: 97%

    Cost of Surgery:  ₹ 3,70,000 approximately

    4. Resurfacing Hemiarthroplasty (Shoulder Resurfacing)

    In this type of shoulder resurfacing, a smooth rounded cap is placed on a humeral head to ensure better movement.

    However, this surgery does not require the total removal of the top of the humeral head or the insertion of a prosthetic stem.

    Benefits

    • Less procedural time
    • Preserves bone stock in active and young patients
    • Decreased incidence of humeral periprosthetic fractures

    Survival Rate After Surgery

    • 10 Year: 89%

    Cost of Surgery: ₹ 4 lakh approximately

    How Should I Prepare for Shoulder Replacement Surgery?

    To prepare the body for surgery, doctors will give you a nerve block (interscalene block) before the surgery. It will numb the shoulder and arm for easy operation. However, even after this, you will receive general anesthesia during the procedure. Other preparations you can make are as under:

    • Doctors may ask you not to eat or drink anything past midnight before the day your surgery is scheduled.
    • Wear something loose and cotton-made. Also, prefer a buttoned shirt as it will be easy to wear when your arms are still numb.
    • During your prior appointments, discuss the list of medications you are taking. If you require any changes or skipping of medications, your doctor will inform you accordingly.
    • Arrange for a cab or support from before who will take you safely from the hospital to home.

    What Are the Risk Factors of Shoulder Replacement Surgery?

    Although a successful shoulder replacement surgery will not let any serious complications emerge, there are a few risk factors involved in the procedure. They are -

    • Infection – This mostly includes minor infections in an area where the surgery has been performed. However, the treatment of this kind of infection requires the right dosage of antibiotics. Though in severity, additional surgery can take place for healing purposes.
    • Loosening of Glenoid
    • Instability or dislocation – In the case of reverse total shoulder replacement, patients may suffer from the dislocation of prosthetics implants from that spot. In this case, it requires additional surgical procedures like reduction to fix the implants.
    • Damage of nerve
    • Shoulder stiffness

    Patients undergoing this surgical treatment must consider stiffness in an affected area of the shoulder before the surgery. However, stiffness post-surgery can result from incomplete rehabilitation or lack of rest.

    Hence, it is always advisable to get the necessary medical attention and physical therapy as per the prescription to restore motion and regain the strength of the shoulder.

    Moreover, these shoulder replacement surgery risk factors can be remarkably intense if a patient already suffers from diabetes. In this situation, healing from such a surgical procedure takes a good amount of time.

    What to Expect Before Shoulder Replacement Surgery?

    Before the surgery, you will be in the preoperative area, where a nurse will monitor your vital signs, blood sugar level, and pregnancy status (if applicable). Further, you will have to change into hospital clothes, remove any jewelry you are wearing and rest on the surgical table for the procedure.

    The surgical gown will give the surgeon easy access to the shoulder, where he will perform a nerve block procedure. Then you will have to wait until they take you to the operating room.

    What to Expect During Shoulder Replacement Surgery?

    The shoulder replacement treatment procedure depends on the surgery the patient is undergoing. The traditional shoulder arthroplasty generally involves replacing the affected joint ball (humeral head) and joint socket (glenoid cavity) with a metal ball and a fine plastic cup.

    This metal-on-plastic implantation is applied virtually in all types of shoulder replacement surgery.

    A total shoulder replacement procedure requires regional anesthesia or general anesthesia depending upon the condition of an affected area. The operation process involves a patient, positioned sitting upright, to be completely or partially sedated.

    Steps of Shoulder Replacement Surgery Procedure

    Here are the steps explaining the procedure of shoulder replacement surgery for better understanding. These are:

    Step 1: In this initial step, a performing surgeon will disassociate the deltoid and pectoral muscle to get a clear view of the affected shoulder. This is for the prevention of any further nerve damage.

    Step 2: Surgeons cut open the front muscle of the rotator cuff, which covers the shoulder area. This allows them to view and operate on the affected arthritic area of the ball and socket.

    Step 3: This section of the joint undergoes the actual removal.

    Step 4: Doctors perform careful insertion of the placement of the implant in the position of the ball, stem, and socket elements.

    Step 5: In this step, an orthopedic surgeon closes and stitches the area with precision.

    Step 6: The final step includes cleaning and stitching the entire external skin area and applying a temporary bandage cover.

    Before proceeding with this entire surgical treatment, a specialist doctor will get multiple X-ray reports which will act as a guiding tool for fixing the affected part.

    Again, some patients suffering from chronic shoulder fractures on the upper arm bone may be recommended partial shoulder replacement by specialists. This partial shoulder replacement is Hemi replacement, where only a ball material undergoes replacement.

    What to Expect After Shoulder Replacement Surgery?

    In most cases, the recovery timeline takes around eight weeks for patients after the shoulder replacement surgery. However, it might take some time for these patients to perform any heavy-loaded work, weight, or strength exercise. It is important to note that any unprescribed movements can lead to serious damage and prolonged pain.

    To prevent this, a doctor runs multiple checks during the early rehabilitation period to confirm the implant's stability. Moreover, a sling's shoulder is fixed with a sling's help during this stage. However, this removal of a sling takes careful consideration under medical guidance for showering and physiotherapy, if necessary.

    In most cases, patients are completely free of any pain within three to six months. This is achievable by following medical guidance, routine check-ups, and proper exercise.

    When Should I Call the Doctor?

    If you are experiencing any issues or side effects, you can contact your doctor for questions and concerns. The symptoms that indicate threat are:

    • Continuous fever
    • Redness
    • Swelling
    • Increased drainage
    • A sudden increase in pain
    • Reduced movement of the arm
    • Change in sensation

    Are There Alternatives to Shoulder Replacement Surgery?

    While surgery is the best option to cure conditions, you can also follow a few conservative alternatives available:

    Physical Therapy

    Since shoulder issues are mainly related to movement restriction and not weight-bearing issues, you can opt for physiotherapy as your treatment option. Physiotherapists suggest exercises that strengthen the muscle and establish a correct balance between the shoulder blade and ball-socket joint.

    Pain Relief Medications

    This is an option you can follow in mild conditions. While your body is healing, take pain medications to make your life comfortable. You can consult a pain-relief team for this treatment. Depending on your condition, they will refer you to take over-the-counter drugs like ibuprofen and paracetamol or codeine products like Co-codamol.

    Injections

    Injections have also been seen to control shoulder pain. Two major forms in which the doctors recommend injections are hyaluronic acid and corticosteroids. These, as a result, reduce swelling, target inflammation, and control pain.

    Support

    Slings and braces serve as support to heal shoulder injuries. This is because mobility is a great factor while recovering from shoulder injuries. In addition, when you are able to avoid stiffening and provide protection, the area heals better.

    Shoulder replacement surgery is extremely successful in combating shoulder pain or fractures. However, it is pivotal to seek multiple doctors' opinions to get the best advice involving treatment.

    What Is the Cost for a Shoulder Replacement Surgery in India?

    Types of Shoulder Replacement Surgery

    Cost of Surgery in India (May Vary Across Cities)

    Traditional Shoulder Arthroplasty (Total Shoulder Replacement)

    ₹ 5 lakh approximately

    Reverse Total Shoulder Arthroplasty (Reverse Shoulder Replacement)

    ₹ 3,24,000 approximately

    Stemmed Hemiarthroplasty (Partial Shoulder Replacement)

    ₹ 3,70,000 approximately

    Resurfacing Hemiarthroplasty (Shoulder Resurfacing)

    ₹ 4 lakh approximately

    Frequently Asked Questions

    Is shoulder replacement surgery painful?

    After undergoing shoulder replacement surgeries, most people have shared their views on getting relief from pain. However, during post-surgery, they might experience a minimal amount of aching due to changes in weather or an increase in the movement of the affected area.

    After undergoing shoulder replacement surgeries, most people have shared their views on getting relief from pain. However, during post-surgery, they might experience a minimal amount of aching due to changes in weather or an increase in the movement of the affected area.

    What are the disadvantages of shoulder replacement surgery?

    Though shoulder replacement procedures offer great relief, there can be some disadvantages like infection, acute pain or stiffness or additional surgery due to tearing of the rotator cuff muscle.

    Though shoulder replacement procedures offer great relief, there can be some disadvantages like infection, acute pain or stiffness or additional surgery due to tearing of the rotator cuff muscle.

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    Disclaimer #1: *Customer can choose options at the time of availing insurance. Premium amount may vary accordingly. Insured is required to disclose any pre-existing condition or on going treatment before policy issuance in the proposal form. 

    Disclaimer #2: This information is added only for informative purposes and collected from different sources across the Internet. Digit Insurance is not promoting or recommending anything here. Please verify the information before making any decisions.

    1. Digit Insurance
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    4. Shoulder Replacement Surgery

    Last updated: 2023-01-30

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