Total shoulder replacement (also called total shoulder arthroplasty) is a surgical solution for shoulder pain that involves replacing arthritic joint surfaces and damaged bone with artificial devices.The two most common reasons for shoulder replacement are either arthritis or a fracture. Severe degenerative arthritis, or osteoarthritis, is when the cartilage has worn away. The smooth surfaces of the head of the humerus (ball) and glenoid (socket) become rough, and they rub against each other rather than glide. A fracture involving the shoulder joint is the second reason someone would need a shoulder replacement.
Other reasons for shoulder replacements include inflammatory arthritis/rheumatoid arthritis, where the cartilage is destroyed by the inflammation. Avascular necrosis is another cause, where there is a loss of blood supply to the humeral head (ball).
The essential part of the surgery is to remove the damaged area and replace it with a shoulder prosthesis (artificial joint). To get to the shoulder joint an incision is made on the front of your shoulder. After exposing the shoulder joint, the damaged ends of the bone are removed. The bone is prepared for the placement of the artificial joint. The artificial joint is made of metal, usually a titanium or a cobalt-chrome alloy. The stem is placed inside the humerus bone. Bone cement may be used to secure the stem in the humerus. The glenoid component is made of a special plastic. The glenoid is cemented into place. Not all patients require a glenoid component. The final decision to use a glenoid component is made during the surgery. Patients with osteoarthritis and inflammatory arthritis generally benefit from the placement of a glenoid component. After the components are in place, the shoulder joint is checked to make sure that the shoulder is stable and has the potential for good motion after rehabilitation.