Anatomic Total Shoulder Replacement
A total shoulder replacement is a surgery that may be performed for patients with Glenhumeral DJD (shoulder arthritis). It involves resurfacing the end of the shoulder bone (humerus) and socket (glenoid) with artificial components. A metal ball is placed on top of a metal stem that is inserted into the humerus while the glenoid is resurfaced with a specialized plastic that interdigitates with the bone. This creates a new gliding surface for the shoulder joint that alleviates pain and leads to improved range of motion, function, and quality of life.
Why Shoulder Replacement
In a traditional (anatomic) shoulder replacement, the ball at the top of the upper arm (the humeral head) is replaced with an artificial ball that is placed onto a stem inserted in the upper arm. The socket is resurfaced with a piece of plastic. With an anatomic shoulder replacement, the rotator cuff remains intact.
An incision is made (about 8 cm) in the front of the shoulder. Dr. Faulkner and his assistant will identify many anatomic structures and will place retractors that help protect those structures and allow for visualization. In order to enter the shoulder joint, a muscle called the subscapularis is released from its attachment to the top of the humerus. The humeral head (ball) and glenoid (socket) are identified and reconstructed based on a 3D blueprint that was obtained prior to surgery. Dr. Faulkner will trial different sizes of the new components to evaluate the best anatomic fit for the patient, and the new components will be fixated to the bone. Dr. Faulkner and his assistant will repair the subscapularis muscle and close the incision. Dressings will be placed over the incision, and the patient will wake up in a sling.
- This surgery is performed under general anesthesia with a nerve block.
- This surgery is usually inpatient, which means the patient generally stays the night at the hospital to allow for nurses to closely monitor the patient. Healthier patients may be able to have an outpatient procedure and return home the same day.
- Surgery typically lasts 1.5-2 hours.
- Patient will be fit for a sling at a preop appointment before surgery and will need to bring this to surgery.
- The sling will be placed on the patient prior to waking up from anesthesia.
- The incisions will be closed with absorbable sutures and a waterproof dressing will be applied. This should be left in place until the first postop appointment.
- The patient may shower right away as long as there is a good seal of the waterproof dressing.
Why Shoulder Replacement
- Decrease pain
- Regain shoulder range of motion and strength
- Allow patients to independently perform activities of daily living
- Return to activities with improved function
- Patients who no longer benefit from more conservative treatments such as physical therapy, pain medication, and steroid injections
- Patients who have significant pain that interferes with their quality of life and activities of daily living
- Patients who want to reclaim their shoulder function
- Typically patients who are over 60 years old
Recovery following a total shoulder arthroplasty is generally 6-12 months. Patients will be placed in a sling for 6 weeks after surgery. They are limited to elbow range of motion and pendulum exercises for this period of time. Physical therapy (PT) will start about 4 weeks after surgery and will last for 3-4 months, depending on a patient’s progress. Physical therapists follow a prescribed protocol outlined by Dr. Faulkner to regain range of motion and strength. Physical therapy and home exercises are a critical part of a patient’s outcomes and quality of life after surgery. The patient should expect to continue to improve with range of motion and strength up to 2 years after surgery, with most of the gains occurring within the first few months after surgery. The patient should plan on being seen in clinic about every 6 weeks for 6 months after the surgery for close monitoring and to ensure any questions are answered. Follow-up appointments with x-rays are recommended at 1 year postop and every 2 years subsequently to ensure there is no evidence of loosening or shifting of the components.
I have been a patient of Dr. Faulkner for over 10 years. He and Cara Cohn, PA , got me ready for my recent shoulder surgery (shoulder replacement), which was very successful, and they got me through my recovery process. They did a great job and I am very thankful. They are highly recommended.
anatomic total shoulder replacement
March 2019, Dr. Faulkner performed a total right shoulder replacement on me when I was 69 years old. Three months later I was fly fishing Gunnison Gorge and four months after surgery I was back to playing golf. Dr. Faulkner was very caring and always gave his full attention to me on my visits. He did a great job on my shoulder and if I need more orthopedic help in the future I will definitely go to Dr. Faulkner. I highly recommend him and his office personnel.
anatomic total shoulder replacement
In meeting Dr. Faulkner you are immediately put at ease. I had a lot of questions about a full shoulder replacement and he took the time to answer them all in a way I was able to understand. His staff was also extremely helpful throughout my whole procedure especially Kamie.
Dr. Faulkner came highly recommended by two of my friends and I would surely highly recommend him also.
I am back to using my shoulder doing everything that I had done previous to my shoulder problems. Actually I forget that I ever needed and that I ever had a complete shoulder replacement surgery. THANK YOU DR. FAULKNER."
Anatomic total shoulder replacement
6 weeks. The sling should be removed at least 3x/day for elbow, wrist, and finger range of motion exercises as will be instructed.
No. Driving with a sling is considered driving impaired and could be subject to a citation.
Yes. Patients are usually unaware of their arm movements at night. The sling helps to ensure that the arm stays in a good position for healing.
Physical therapy typically starts 4 weeks after surgery.
2 days after surgery. You will have a waterproof dressing on that should be left in place until your first postoperative appointment.
The ice machine should be used for about 30 minutes at least 3 times a day until your first postop. You may ice more frequently if desired.
An anesthetic injection performed by the anesthesiologist to turn off pain signals that go to a targeted region.
This will be discussed at your preop appointment. If a narcotic is prescribed, the risks and side effects will be reviewed with you. We encourage you to try and discontinue these by your first postop appointment. Depending on your health history, it is encouraged to take anti-inflammatories and Tylenol instead of the narcotics.
The overall risk of a complication is less than 1%. The most common risk is shoulder stiffness from scarring. Other more rare risks include re-tearing of the subscap muscle, infection, bleeding, and persistent pain.