Shoulder Arthritis
 
ghj_small.jpgMany people will be aware of hip and knee arthritis and the fact that these worn out joints can be very successfully replaced with artificial ones that get rid of pain and return function. Not as many people know that the shoulder joint can also become arthritic resulting in pain, stiffness and loss of use and that it, too, can be replaced with a new metal and plastic joint.

So, if you are in your 60's or older and realise that your shoulder is becoming stiffer and more painful then there is a reasonable chance that you may have arthritis. Often, however, you will be told that you have a 'frozen shoulder' or maybe 'tendonitis'. But do not accept these diagnoses until an x-ray has been done because that simple, cheap and readily available investigation will tell the story.

cuffarthrop_small.jpgI will examine you, review the x-rays and probably also organise either an MRI or CT scan to get the full picture about your shoulder arthritis. Then we will discuss the operation, it's benefits and risks and the rehabilitation required after the surgery.

The procedure is carried out under a combination of a general anaesthetic and an inter-scalene block (see anaesthesia for shoulder surgery) and takes between an hour and an hour and a half depending on whether or not the socket is replaced.

aequalis_small.jpgThe worn out humeral head (the ball at the top of the upper arm bone) is removed and a new metal ball positioned to replace it. In some cases the socket also need to be replaced.

As with the hip, there are many different types of shoulder replacement available. I favour what is called an 'anatomical' replacement where the shape of the implant exactly matches the shape of the normal humeral head. I also try to do an uncemented implant because we know that, over time, the cement can weaken and cayse the implant to loosen. At present I am using a relatively new shoulder replacement which, I believe, answers all the problems raised by the existing options; it has an anatomically shaped head; it is uncemented; and it allows for replacement of the socket when this is required.

Afterwards your arm will be in a sling for about 4 weeks but you will come out of this regularly to do exercises both at home and under the guidance of the physiotherapists. Your fingers and elbow will be working normally straight away.

Physiotherapy (and hydrotherapy, if available) is essential in order to get the best result from the operation. You will only need to be in hospital for 2 days or so and physio will start there and continue as an out-patient.

deltashoulder_small.jpgA shoulder replacement is certainly a major undertaking and it will take at least 6 months and probably up to a year to make a complete recovery from it! However you should be painfree within a month and moving your new shoulder nicely within 2 to 3 months.