Total Shoulder Replacement

The shoulder joint is formed by the shoulder blade, collar bone, and upper arm, or the scapula, clavicle, and humerus. The shoulder joint is kept stable by the muscles and tendons of the rotator cuff. The top of the humerus (ball) and the socket of the scapula (glenoid) are covered with smooth articular cartilage. When that cartilage is damaged through wear and tear, called osteoarthritis, or chronically inflamed by rheumatoid arthritis, shoulder arthroplasty can offer a solution for the resulting pain and limitation.

In total shoulder arthroplasty, or shoulder replacement surgery, damaged bone and cartilage are removed and replaced with artificial components. Shoulder replacement surgery is used to help provide pain relief and reduce limitations caused by shoulder arthritis or severe fractures that have disabled the shoulder joint.

A skilled orthopedic surgeon will be able to perform an exam and use X-rays and imaging to diagnose your issue and provide the right treatment for you.

Is Shoulder Replacement Surgery Right for You?

Your surgeon will ask you questions about your shoulder pain and how it is impacting your ability to function. Before recommending shoulder replacement surgery, your surgeon may suggest other treatments, such as taking anti-inflammatory medications, getting steroid injections, or undergoing physical therapy.

If nonsurgical treatments do not relieve pain, joint replacement could be a good option for you. This may mean total shoulder replacement, partial shoulder replacement (shoulder hemiarthroplasty), or reverse total shoulder replacement:

•    Shoulder hemiarthroplasty, or partial shoulder replacement, is used when there is damage to the humerus (upper arm bone) at the head of the humerus (ball).
•    Reverse total shoulder arthroplasty, or reverse shoulder replacement, is used for someone with unrepairable damage to one or all of the muscles that make up the rotator cuff or rotator cuff tendons.
•    Total shoulder arthroplasty, or total shoulder replacement, is used when there is damage to both ends of the ball-and-socket.

If you have moderate to severe arthritis, from rheumatoid arthritis to osteoarthritis, and your shoulder pain is interfering with your daily life—even while you are resting—you may be a good candidate for joint replacement surgery. If you have post-traumatic arthritis due to a fracture or other injury, you may also benefit from shoulder arthroplasty.

You should seek out an experienced orthopedic surgeon to perform your shoulder arthroplasty. This doctor should be skilled at performing the surgical procedure and also have the ability to assess the extent of the damage prior to surgery. At Rebound Orthopedics & Neurosurgery, Gregory D. Gramstad, M.D., Jesse McCarron, M.D., and Anthony S. Wei, M.D., all have exceptional training and experience in shoulder joint replacement and the latest surgical procedures. Our shoulder joint replacement experts are available at our Vancouver, Rose Quarter, Salmon Creek, and Lake Oswego locations.

What to Expect During Your Shoulder Replacement

After you are given anesthesia, your surgeon will make an incision between two muscles on the front of your shoulder—the deltoid and pectoralis major. During a partial shoulder replacement, the damaged humeral head is removed and replaced with a stem that has a round metal ball. During a traditional total shoulder replacement surgery, the damaged humeral head is removed and replaced with a metal humeral component and the glenoid is also resurfaced or cleaned and replaced with a plastic glenoid component. A reverse total shoulder replacement is similar; however, the ball (humeral head) is replaced with a socket (glenoid), and the socket is replaced with a ball.

After surgery, you will be moved to a recovery room while your anesthesia wears off. When you wake up, you will be wearing a sling. You should carefully follow your surgeon’s instructions regarding when you can remove the sling and move your elbow, wrist, and fingers.

Shoulder Replacement Recovery, Risks & Rehabilitation

Your orthopedic surgeon will provide you with specific instructions about what you can and cannot do while your shoulder is healing. You will need to keep the sling on for several weeks after surgery, do exercises and stretching activities consistently, and complete physical therapy to help your shoulder heal properly.

As with any surgery, there is a risk of infection or blood clots. You should also avoid lifting heavy weights overhead with the weight behind your head, or you risk reinjuring your shoulder.

The Region's Most Preferred Total Shoulder Care in Vancouver, Portland & Lake Oswego

If you're ready to discuss total shoulder replacement surgery or other treatment options for your shoulder problem with one of our shoulder experts, Gregory D. Gramstad, M.D., Jesse McCarron, M.D., and Anthony S. Wei, M.D., visit us in Vancouver at our Vancouver or Salmon Creek locations; in Portland at our Rose Quarter location; or at our Lake Oswego location. You can request an appointment online or call us at 1-800-REBOUND.