Shoulder pain can be incredibly disabling. When no longer responding to nonoperative modalities, it is beneficial to know which operation will best allow the shoulder to move appropriately with less pain. When total shoulder replacement surgery is the best option for many patients, knowing it can help to know when it is most effective. Dr. Nagraj Shetty at Arthroscopy Surgery Mumbai aim is to educate you about your shoulder problem, treat problems in the best way for each individual and to help you the patient get better with us being the top total shoulder replacement surgeons.
This in-depth guide discusses when total shoulder replacement is a better choice than other shoulder surgeries, the process of deciding between procedures and what to expect when patients have different experiences.
What Is Total Shoulder Replacement?
Total shoulder arthroplasty is the surgical replacement of the ball and socket of the shoulder with like components. This is the most common operation recommended for patients whose shoulder joint has been destroyed due to arthritis, fracture or collapse of the joint surfaces.
This is as opposed to arthroscopic surgery and other minimally invasive procedures in which the worn out parts of the joint are not replaced. This is a way to decrease pain and return the range of motion that can no longer be achieved with other surgical interventions.
At What Point Will a Surgeon Recommend Total Shoulder Replacement?
One of the most common questions we receive in the clinic is: “When do you guys recommend a total shoulder replacement?”
You may need a total shoulder replacement if:
- There is a very significant joint destruction, typically secondary to osteoarthritis or rheumatoid arthritis.
- Imaging reveals loss of normal joint space at the shoulder.
- Pain that is constant and interferes with daily activities despite non-surgical treatment, such as pain medication, physical therapy, or injections.
- Arthroscopy or other surgeries are not most likely to give permanent relief since the injury inside the joint has already been extensive.
- Instability or deformity of the shoulders cannot be addressed by soft tissue procedure alone.
At Dr. Nagraj’s Clinic they approach each patient with a proper assessment of the disorder, collect data on symptoms and doctor’s tests, and summarize the findings from imaging analysis thoroughly before they decide for an appropriate plan of action.
Deciding between total shoulder replacement and other types of shoulder surgery
A frequent question from patients is how to know when surgeons choose between replacement and other types of surgical procedures on shoulders.
Key Factors in Decision Making
Extent of Joint Damage
If the cartilage is completely worn and the bone surfaces are damaged, alternative surgical procedures such as arthroscopic treatment may not yield long-lasting results. In such a case, total shoulder replacement is the best choice.
Patient Age and Activity Level
Young patients with milder joint status might benefit from incising torn tissue, particularly the SLAP lesion, whereas older diseases may be more prone to fail same, and other procedure is done. But if you have long-standing, progressive joint degeneration, in the end you will recover better with a replacement.
Functional Goals
For patients who are most interested in achieving a dramatic reduction in pain and getting as much mobility back as possible, shoulder replacement is usually the solution.
Previous Surgeries
Patients with previous shoulder surgeries that failed to correct their symptoms may be candidates for a total shoulder arthroplasty as the joint degeneration progresses.
Presence of Rotator Cuff Tears
Massive rotator cuff tears with arthritic changes may require a special type of shoulder replacement, for example reverse total shoulder replacement and that is surgery managing by expert in shoulder replacement.
The choice is never acted out in a vacuum. Your symptoms, desired outcome, imaging results and overall health shape how our shoulder specialists decide which surgery provides the best amelioration.
Is Total Shoulder Replacement Better Than Arthroscopic Shoulder Surgery?
Is One Type of Shoulder Surgery Better Than the Other? A common concern that patients have is if shoulder replacement is better than arthroscopic shoulder surgery.
A shoulder arthroscopy is a minimally invasive surgery with the use of small incisions and camera to fix soft tissue structures or remove loose fragments. While arthroscopy has its advantages for certain cases, it is not always the optimal option.
When Arthroscopic Surgery Works Best
Here are some of the uses for arthroscopic procedures:
- Rotator cuff repairs
- Labral tears
- Excision of osteophytes or loose bodies
- Treatment of some types of shoulder instability
Typically, these are soft tissue problems rather than significant joint surface problems.
When Total Shoulder Replacement Is a Better Option
Total shoulder replacement is indicated if and when:
- Arthritis involving the joint surface is advanced
- Pain and stiffness arise from bony wear.
- Prior arthroscopic procedures have failed to prevent progression of the joint deterioration
In most of these circumstances, arthroscopy can afford only temporary relief if the underlying articular surface damage is not dealt with. Total shoulder replacement addresses the problem at its source by replacing the degenerated joint, and provides longer-lasting relief from pain with better function.
At Dr. Nagraj’s Shetty Clinic, our most excellent shoulder replacement surgeons assess whether an arthroscopy or even a replacement will offer you the best and most meaningful results for your personal needs.
Advanced Shoulder Surgery Options Explained
The Surgical System has revolutionized shoulder surgery. Here are a few alternate shoulder surgeries your surgeon may consider aside from standard total shoulder replacement.
Partial Shoulder Replacement (Hemiarthroplasty)
This operation replaces only the ball of the shoulder joint. It is rarely considered for patients with certain types of fractures or less extensive wear of the socket. But when the joint surfaces are destroyed on both, total replacement works better.
Reverse Total Shoulder Replacement
This modification is suitable for patients with rotator cuff tear arthropathy. The ball and socket are reversed so that the deltoid muscle is able to move the arm since the rotator cuff is no longer functioning.
Arthroscopic Repair Procedures
Given that soft tissues such as labrum or rotator cuff are focused pain generators, arthroscopic methods can be employed when the pain comes from these structures. These are less invasive procedures, but may not be appropriate for patients with severe arthritis.
Shoulder Resurfacing
In some cases a surface replacement may be considered, where only the damaged surfaces are surfaced and not replaced. This can save more bone, but it’s not appropriate for everyone.
It is not only the type of operation, but a surgical decision in terms relative order of magnitude that needs to be made by a shoulder replacement surgeon who has seen and can appreciate the range of disease processes of the shoulder and the available surgeries.
Total Shoulder Replacement Surgeons Can They Help When Shoulder Surgery Has Failed in the Past?
Many patients are concerned about constant pain after a previous shoulder operation. The good news is:
Yes, total shoulder replacement doctors can assist if prior shoulder surgery failed.
In some cases, previous operations will have taken care of only part of the problem. For instance, arthroscopic repairs may repair a labral tear but don’t stop arthritis from advancing. In the cases, patients may have on-going pain and functional impairment.
We have had a vast experience in evaluating and treating patients with previous shoulder surgeries in our department at Arthroscopy Surgery Mumbai. We assess:
- What Occurred in a Previous Operation
- Why pain and symptoms persist
- Whether joint degeneration has progressed
- Which one will have the most favorable long term outcome?
Among those who have not been adequately treated, the total shoulder replacement yields excellent results.
Why Select Arthroscopy Surgery Mumbai for Shoulder Treatment?
At Dr. Nagraj’s Arthroscopy Surgery Mumbai Clinic, we devote ourselves completely in delivering world class care for Shoulder disorders. All of our total shoulder replacement surgeons hold years of specialized experience for the treatment of difficult to diagnose shoulder problems. Whether you need a total shoulder replacement specialist or you are researching the latest in advanced shoulder surgery options, we customize your plan of care and help achieve optimal results.
We know that surgery is a difficult decision. That is why we take the time to discuss all your options, answer your questions and assist you in making an educated decision.
Conclusion
Clinical work-up is necessary to differentiate total shoulder replacement surgery from other related operations. Total shoulder replacement may offer the most lasting relief and improvement in function when the joint is severely damaged by arthritis, chronic pain or when previous replacement surgeries have failed.
If you’re suffering from chronic shoulder pain and are looking for the best surgery available, then discover our expert total shoulder replacement surgeons in Mumbai at Arthroscopy Surgery Mumbai. Through extensive diagnostic testing coupled with precise operative treatment, we allow our patients to restore normal pain-free function and enable them to return to the activities that they love.
Frequently Asked Questions
In what cases do doctors suggest total shoulder arthroplasty surgery?
Total shoulder replacement is advised where there is joint arthritis with destruction of the bone ends, pain that has become severe and interferes with activities of daily living, a lack of relief from non-operative treatments and extensive damage seen in particular on x-ray.
How do surgeons choose between replacement and other shoulder surgeries?
Decisions are made based on degree of arthritis, patient age, activity level, previous surgery history and functional goals. Replacement typically is selected when joint surfaces are significantly damaged.
Is total shoulder replacement superior to arthroscopic shoulder surgery?
For joint surface disease and more advanced arthritis, total shoulder replacement is usually better in the long run. Arthroscopy works best for soft-tissue repairs and is less effective when cartilage or bone surfaces are damaged.
Can total shoulder replacement doctors assist if prior shoulder surgery has not worked?
Yes. If previous surgical options have failed to give long lasting relief and the joint is degenerate, shoulder replacement surgery can often give excellent pain relief and improve shoulder function.
