Shoulder Pain Relief: Surgical Options

Most people will not need shoulder surgery, but in many cases, surgery may be effective in minimizing or eliminating your shoulder pain when other treatment methods have failed. Many advances have been made in recent years, allowing for less-invasive surgical procedures. Such minimally invasive procedures are revolutionizing the way patients experience and recover from surgery, often resulting in less postoperative pain, a faster recovery period, and a shorter hospital stay.

Often the first surgical treatment for shoulder osteoarthritis is arthroscopy, a procedure used to see, diagnose, and treat problems inside the joint. Arthroscopy typically involves inserting a small camera into the shoulder and then treating identifiable problems. Some of the more common procedures performed during arthroscopy include:

• Trimming damaged cartilage
• Removing loose debris within the shoulder (debridement)
• Irrigating the inside of the shoulder (lavage)

In both partial and total shoulder replacement surgery, the bone surfaces and cartilage that have been damaged are removed and replaced with artificial surfaces (implants).

In cases where significant damage is limited to only the humeral (ball) side of the joint, your doctor may consider a procedure that preserves the healthy side of your shoulder. This is called a partial shoulder replacement. In a partial shoulder replacement, only one side (the diseased portion) of the joint is replaced, leaving the healthy portion untouched.

A successful partial shoulder replacement can relieve pain and preserve more of your natural anatomy. It may delay, and, in some cases, prevent a more extensive total shoulder replacement, which replaces both parts of your shoulder.

In total shoulder replacement surgery, your ball and socket that have been damaged by arthritis are removed and replaced with artificial parts made of metal and a very durable plastic material implants. These implants are shaped so that your shoulder joint will move in a way that is very similar to the way the joint moved when it was healthy.

The part that replaces the ball consists of a stem with a rounded metal head. The part that replaces the socket consists of a smooth plastic concave shell that matches the round head of the ball. When both sides of the joint are replaced, we call it a total shoulder replacement.

If your rotator cuff is so damaged that it would not be able to support a traditional joint replacement, your doctor may consider reverse shoulder replacement.

Just as with traditional shoulder replacement, the parts of your shoulder that have "worn out" and rub together are replaced with metal and plastic parts that can move smoothly.

The difference with reverse shoulder replacement is that the part of your arm bone and shoulder blade that serve as the ball and socket are reversed; the "ball" is attached to your shoulder blade and the "socket" is attached to your upper arm. This allows for your deltoid muscles to compensate for your damaged rotator cuff, resulting in increased stability, strength, and range-of-motion to your shoulder joint.