I Have Bad Arthritis In The Shoulder But I'm Afraid Of Surgery... What Should I Do?

Joint replacement surgery for arthritis has becomeuntil at least the age of 60.
commonplace nowadays when it comes to areasAs with other replacement procedures, a revision
such as hips or knees.operation- a replacement of a replacement is a
However, there is still the notion that shoulderdifficult, risky, and complex procedure. Patients under
replacement is difficult and not very successful. It'sthe age of 60 might want to consider lesser options
something to consider only as the very last resort...before moving onto shoulder replacement.
and even then avoid it if possible. Why is this theShoulder fusion is another procedure that can be
case?considered. While pain is ameliorated, function of the
One reason is that shoulder replacement is notshoulder is markedly restricted so it's not an option
commonly done. Only about a tenth as manyfor many patients.
shoulder replacements are done as hip or kneeThe reason total shoulder replacement is such a
replacements. However, new data from a Johnschallenging operation is that it involves removing the
Hopkins study has demonstrated that while lesshead of the humerus (the top of the upper arm
commonly performed, shoulder replacement actuallybone) and replacing it with a new prosthetic metal
has fewer complications and shorter hospital staysball. Then, a resurfacing of the glenoid (shoulder
than either knee or hip replacement.socket) is done by by attaching a second
Shoulder replacements are less common than knee orsaucer-shaped plastic component to the shoulder
hip replacement for three major reasons.blade.
The first is that the most common form of arthritis,Since the shoulder is a smaller and more complex
osteoarthritis- is a disease of weight-bearing jointsjoint than the knee or hip, it is more difficult to place
and the shoulder is not a weight-bearing joint.the prosthesis perfectly. Getting to the shoulder joint
Also, many people don't realize shoulder replacementis made more difficult because of the many nerves,
is an option or they may lack access to surgeonstendons and blood vessels in the area.
who can perform shoulder replacement surgeryAlso, the anatomy of the shoulder varies a lot from
because it is such a specialized procedure.person to person so many times standardized parts
Finally, many physicians have not been exposed todon't fit well. Placement of the implant is very
the excellent results that can be achieved, so theydemanding from a surgical viewpoint. Done correctly,
are often reluctant to advise it for their patients.shoulder replacement results in a well-functioning
As with all joint replacement operations, the singleshoulder with a durable implant.
biggest determinant of success is the skill andAlso, and often most importantly, the operation
experience of the surgeon.eliminates the arthritis pain.
This is a particularly complex surgery, so it isAfter the procedure, patients can begin to move
mandatory to find a highly skilled surgeon at a majortheir shoulder right away. They should remain in the
medical center, particularly a center specializing inhospital at least two days though. Several months of
orthopedic surgery, where a large number ofphysical therapy are necessary to gain full functioning
shoulder replacements are done.and range of motion in the shoulder.
So if you're a patient with arthritis when do youMost patients can raise their arm by six weeks and
know you might be a candidate for shoulderresume full activities after three or four months.
replacement? If you're experiencing significant painPatients experience the most dramatic improvement
due to your arthritis that is disabling or interferingin the first four months. However, they will still make
with sleep, that's an indication. Also, if you are havingprogress over the next year.
difficulty with daily functioning as a result of arthritisThey often can return to their previous activities.
in the shoulder, that would be another indicator thatHowever, surgeons caution patients that excessive
you should at least look into it.overuse of the joint will wear it out faster.
While shoulder arthritis is generally a condition thatSo... shoulder replacement surgery can be added to
occurs in older people, the patient must otherwise bethe growing number of treatment options available
healthy enough to undergo the surgical procedure.for people with shoulder arthritis that has failed to
Shoulder prostheses last an average of 15 to 20respond to more conservative measures.
years so if possible, it's best to delay the surgery