Many people know someone with an artificial knee or hip joint. Shoulder replacement is less common. But it is just as successful in relieving joint pain. Shoulder replacement surgery started in the United States in the 1950s. It was used as a treatment for severe shoulder fractures. Over the years, this type of shoulder surgery has come to be used for many other painful conditions of the shoulder, including:
- Osteoarthritis (degenerative joint disease)
- Rheumatoid arthritis
- Post-traumatic arthritis
- Rotator cuff tear arthropathy (a combination of severe arthritis and a massive non-reparable rotator cuff tendon tear)
- Avascular necrosis (osteonecrosis)
- A failed previous shoulder surgery
Today, many surgeons use shoulder replacement surgery. About 23,000 people have the surgery each year. This compares to more than 700,000 Americans a year who have knee and hip replacement surgery.
The shoulder is a ball-and-socket joint that enables you to raise, twist and bend your arm. It also lets you move your arm forward, to the side and behind you. In a normal shoulder, the rounded end of the upper arm bone (head of the humerus) glides against the small dish-like socket (glenoid) in the shoulder blade (scapula). These joint surfaces are normally covered with smooth cartilage. They allow the shoulder to rotate through a greater range of motion than any other joint in the body.
The surrounding muscles and tendons provide stability and support. Unfortunately, conditions like those listed above can lead to loss of the cartilage and mechanical deterioration of the shoulder joint. The result can be pain. You can have a stiff shoulder that grinds or clunks. This can lead to a loss of strength, decreased range of motion in the shoulder and impaired function. In this case, x-rays of the shoulder would show:
- Loss of the normal cartilage joint space
- Flattening or irregularity in the shape of the bone
- Bone spurs
- Loose pieces of bone and cartilage floating inside the joint
In severe cases, bone-on-bone arthritis may lead to erosion or a wearing away of the bone.
Patients with arthritis typically describe a deep ache within the shoulder joint. Initially, the pain feels worse with movement and activity, and eases with rest. As the arthritis progresses, the pain may occur even when you rest. By the time a patient sees a physician for the shoulder pain, he or she often has pain at night. This pain may be severe enough to prevent a good night's sleep. The patient's shoulder may make grinding or grating noises when moved. Or the shoulder may catch, grab, clunk or lock up. Over time, the patient may notice loss of motion and/or weakness in the affected shoulder. Simple daily activities like reaching into a cupboard, dressing, toileting and washing the opposite armpit may become increasingly difficult.
Many thousands of patients have experienced an improved quality of life after shoulder replacement surgery. They experience a decrease in shoulder pain, improved motion and strength and better function of the entire shoulder. Talk to your orthopedic surgeon to learn more about shoulder surgery and if it could be the right choice for relief of your shoulder pain.