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Shoulder Replacement

Get permanent relief from the shoulder pain that has been affecting your daily life! Get shoulder replacement surgery at Sri Balaji Hospital, Chennai.
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Image showing a man with shoulder pain.

Natural Anatomy of Shoulder

The shoulder joint is a typical example of the ball & socket joint. The shoulder joint is formed by the upper end of the arm bone, which is known as the head of the humerus (“the ball” of the ball & socket joint) and the joint surface of the scapula (also known as the shoulder blade) which forms the “socket” of the ball and socket joint.

About Shoulder Replacement Surgery

While shoulder joint replacement may be less frequent compared to knee or hip replacement, it is equally effective in alleviating joint pain and restoring function.

When non-operative treatment modalities like medications, physiotherapy and targeted physical therapy/ exercises for the shoulder are no longer helpful for relieving pain, shoulder replacement is recommended. Also, if the internal damage to the shoulder is beyond repairable, then the option of replacing the irreparable shoulder joint will be considered.

Types of Shoulder Replacement

During a shoulder replacement surgery, our skilled medical professionals remove the compromised components of the shoulder and replace them with high-quality metallic and non-metallic implants. This meticulous process restores the natural anatomy of the shoulder joint, ensuring its optimal function and longevity. Below mentioned are some of the shoulder replacement procedures carried out at Sri Balaji Hospital, Chennai:
Total Shoulder Replacement
Partial Shoulder Replacement (Hemi Shoulder Replacement)
Reverse Shoulder Replacement
Traditional total shoulder replacement surgery is a precise procedure that entails the replacement of damaged or diseased joint surfaces with a medical-grade metal ball affixed to a medical-grade polyethylene socket and a stem. The sizing of these components is customised to meticulously recreate the natural shoulder anatomy, aiming for the highest degree of accuracy for each individual's unique case.

All of the above causes for shoulder replacement must hold good to consider this type of surgery. However, the only difference in its indication is that while the ball of the shoulder (the humerus head) may be damaged or diseased, the anatomy of the socket (glenoid or the cup of the scapula) remains perfectly intact.

When the decision of total shoulder replacement or hemi shoulder replacement is being taken into consideration, it is important to remember that most studies have shown that patients with arthritis of the shoulder get better relief from pain and loss of functions from total shoulder arthroplasty than from hemiarthroplasty.

Reverse total shoulder replacement is reserved for people with:

  • Long-standing/ completely torn or irreparable rotator cuffs with severe pain and a feeling of arm weakness.
  • Combination of rotator cuff tears (cuff tear arthropathy) and severe arthritis.
  • History of a failed shoulder replacement.

In reverse total shoulder replacement, the positions of the artificial socket and the metal ball are switched. That is, the metal ball is attached to the shoulder blade (the natural site of the socket), and an artificial medical-grade socket is attached to the upper arm bone (the natural site of the ball of the joint).

The rehabilitation program at Sri Balaji Hospital is designed to enable the patient to successfully do the recommended physical therapy at home without assistance and with immense ease and comfort.

Our doctors may suggest the following medication at the time of discharge:

  • Mild antibiotic
    A week’s dosage to protect the patient from home-acquired infections.
  • Anti-coagulant (only if necessary)
    Our doctor may recommend anti-coagulants for certain patients if their health status deems it necessary. They will also prescribe the dosage based on the patient’s medical requirements.
  • Pain relief
    A mild pain relief tablet for three days.

The patient will be ready for suture (stitch) removal by the 14th day. Between the date of discharge and suture removal, the patient may require one or two dressings. Patients can also opt for surgical wound dressing and suture removal to be performed from the comfort of their homes.

When Will You Require Shoulder Replacement?

Severe shoulder pain that interferes with everyday activities, such as self-care, moving, removing items from a cupboard, and independent use of the restroom.
Constant pain even while at rest. This pain may be severe enough to prevent a good night's sleep.
Progressive reduction or loss of movement with or without a feeling of weakness in the affected shoulder.
Failure of all other non-operative or minimally invasive (keyhole) surgeries to substantially improve the symptoms.
The irreparable condition of the shoulder's anatomy has been determined through a clinical examination, as well as assessments using X-rays and/or MRI scans of the affected shoulder.

The Science Behind The Success Of Reverse Shoulder Arthroplasty

After this surgery, the primary force driving the shoulder and acting as the fulcrum is the large deltoid muscle. This effectively relieves the severely or irreparably torn rotator cuff from lifting the arm.

Contact usA patient in pain caused by a shoulder problem.

Indications for Shoulder Replacement Surgery

Arthritis of the shoulder caused by the natural degenerative process associated with aging.
Arthritis of the shoulder caused by degenerative joint diseases such as rheumatoid arthritis.
Severe irreparable and long-standing/ untreated rotator cuff tears.
A vascular necrosis of the head of the humerus (loss of blood supply to the head of the humerus resulting in progressive arthritis of the ball of the shoulder).
Shattered shoulder (4 or more parts of the fracture involving the head of the humerus or “the ball” of the ball & socket joint).

Myths That We Break Surrounding Shoulder Replacement Surgeries

Technological advancements in the field of joint replacement surgeries as a whole, especially shoulder replacements, have made it a very safe and patient-friendly procedure.

Shoulder mobility icon.
Will you lose shoulder mobility?

Many patients fear a complete loss of shoulder mobility post-surgery. While temporary stiffness during the recovery period is normal, most individuals discover improved shoulder mobility following their procedure.

Weight Restrictions icons.
Will You Have Permanent Weight Restrictions ?
Some may believe they can never carry heavy weights again after shoulder replacement surgery. However, once fully recovered, patients can comfortably resume their regular activities. It's essential to exercise patience during the recovery phase.
Raise Your Arms icon.
You Will Be Able to Raise Your Arms

Individuals might worry about being unable to raise their arms after a shoulder replacement. In reality, shoulder replacement is a highly effective solution for those struggling to lift their arms. After a successful recovery, patients can rotate and raise their arms without any difficulty. Your shoulder will no longer be a limitation.

How to Plan for Shoulder Replacement Surgery

Pre-Operative Period
The Procedure
Post-Operative Period
Expected Results by Third Week
Expected Results Within the Sixth Week
Follow-Up Doctor Visits

An initial assessment of the painful joint will be frequently followed by an x-ray assessment of the joint. You might also require an MRI or CT image examination of the joint.

Having assessed the patient thoroughly (the joint as well as the general condition of the individual), if there is a need for surgery, the patient will undergo some tests to confirm that the patient is indeed in good health to benefit from this surgery. The evaluation of the patient's health usually involves (but not limited to) the following tests:

  • Blood tests
  • ECG and echocardiogram performed by a doctor certified & specialised in cardiology (cardiologist).
  • Pre-operative assessment by the anesthesiology specialist who will be in charge of the patient’s intra-operative anaesthesia.
  • Pre-operative testing may include additional patient-specific tests if they are deemed necessary based on routine pre-operative blood tests or if recommended by the specialists involved in the pre-operative health assessment.
Depending on the extent of your joint damage, your physician may recommend one of the following shoulder replacement procedures:
Anatomic Total Shoulder Replacement
In this procedure, both the ball and socket of the shoulder joint are replaced with implants that closely resemble the natural bone structure.
Partial Shoulder Replacement
For cases where only the ball side of the joint is damaged, a partial shoulder replacement may be advised. It involves the replacement of the joint's head (ball) to restore functionality.
Reverse Total Shoulder Replacement
This procedure entails the replacement of both the ball and socket but with a unique twist. The ball is affixed to the shoulder blade, while the socket is attached to the upper arm bone. Typically, this option is preferred when the rotator cuff is badly damaged.
Most patients undergoing these surgeries receive general anaesthesia to induce a deep sleep. Additionally, a nerve block is administered to numb the shoulder, ensuring effective pain control post-surgery as you awaken from general anaesthesia.
X-rays showing before and after the shoulder joint surgery.

The patients are usually fit with an arm sling to support the upper limb and the operated shoulder for 2 weeks after surgery. However, the operated person will be allowed to start protected, gentle and passive movement of the operated shoulder (with little-to-no pain) within 24 hours. Based on the physical therapy outcomes, the patient is usually discharged in 3- 4 days and can go home pain-free.

Discharge medication: the patient may be put on the following types of medication at the time of discharge:

  • Mild antibiotic- to protect the patient from home-acquired infections for a total period of seven days.
  • Pain relief- A mild pain relief tablet for 3 days.

The patient will be ready for suture (stitch) removal by the 14th day. Between the date of discharge and suture removal, the patient may require one or two dressings. These dressings, including the suture removal, can be performed in the comfort of their own home if they wish to opt for that feature.

X-ray of Post-Operative  Shoulder Replacement.

The patient will be pain-free from the operative pain as well as the pre-operative disease pain. The patient will be self-sufficient and can use the restroom with little to little-to-no support.

The patient will now be confident to take care of themselves without the assistance of any other attendant. By this time, the patient, now free from all pains and in an advanced stage of recovery and rehabilitation, will be fit to resume their daily activities, including returning to work.

  • X-ray of a fractured left shoulder.
  • Post-operative X-ray of a fractured left shoulder.
  • X-ray of a fractured right shoulder.
  • Post-operative X-ray of a severely damaged knee of an 81-year-old lady.
  • X-ray of a severely damaged knee of an 81-year-old lady.
By this time, the patient is pain-free and can enjoy their body’s peak performance, including riding  2-wheelers/ 4-wheelers. They can also resume more strenuous activities at this juncture, which include cycling, running, etc.
After the 6th week, the patient will be expected to visit us only twice more, once in the 3rd month (12 weeks) and one final visit in the 6th month (24th week).
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