Many types of shoulder injuries are treated by noninvasive means. However, with some cases of severe arthritis, the damage to the joint is so extensive that a complete surgical replacement becomes necessary. Over the course of treatment, you and your doctor will need to be able to determine when that time has come.
Symptoms of severe arthritis: Pain and stiffness are the main indicators of damage. In the shoulder, like with other joints, this eventually causes severe limitation of range of motion. There can also be a feeling of grinding or catching as the tip of the humerus—the ball in the joint socket—moves around.
Tests that might be done: X -rays are commonly done to start evaluating the level of damage. Especially if there’s a record of past testing, this will give a sense of changes or abnormalities in the bone and cartilage. Doctors will have patients perform certain activities to check for strength and range of motion.
Activity modification/interference: One main determination in what level of treatment the patient needs is how badly the pain and stiffness are interfering with everyday activities. This can depend partly on the patient’s lifestyle—for example, someone working a job with lots of lifting and carrying might be more affected at a lower level of pain.
In some cases, activity or lifestyle modification can help to mitigate and compensate for pain. However, if attempts to work around the symptoms become impractical or are causing significant problems in the patient’s lifestyle, it is a sign that surgical replacement may be necessary.
Physical therapy progress: For many types of shoulder injuries, this is a preferred form of first-resort treatment. Often, doctors will consider shoulder replacement if the patient is not making expected progress in physical therapy, or if the pain and damage are too severe even for basic exercises.
Upsides to shoulder replacement: Typically, this is effective in helping patients carry out ordinary tasks with significant reduction in pain. Most patients are said to regain about two-thirds of normal shoulder movement. It also prevents further deterioration of the joint.
It is considered to have high potential for effectiveness, with failure rates estimated to be quite low. Stretching exercises and other physical therapy begins about six weeks after surgery, continuing at a higher level around three months after surgery.
The typical lifespan of the replacement parts is long enough that patients older than 60 will typically not need another replacement later on.
Downsides to shoulder replacement: As with other surgeries, there is some risk of infection or difficulty with healing, and some risk from anesthesia. Postoperative infection risk is estimated at around 2 or 3 percent, and is more common in patients who are immunosuppressed from corticosteroids, or who have other ongoing health risks.
Often, shoulder replacement patients will eventually need further surgery, since the artificial joints have an average lifespan of around 10 to 15 years. This makes them a less attractive option for younger patients.
Also, while it does improve on current function, it won’t restore your condition to where it was before there was any damage. There may still be severe stiffness and low range of motion.
Rare potential complications include injury to the nerves or fracture of the upper arm bone, either during or after surgery. Nerve injuries typically improve, however. Slightly more common is dislocation, often from the soft tissue being stretched too far too soon after surgery.
For severe arthritis that hasn’t responded to other forms of treatment, including physical therapy and medication, try consulting with top orthopedic surgeons in Phoenix about what kinds of more extensive treatment might be a good option.
