The shoulder is made up of bones, joint, ligaments, and muscles that hold the shoulder in place and allow movement. Articular cartilage is the white slippery material that covers the surfaces where bones meet in the joint to cushion and reduce friction. The shoulder joint is a large ball-and-socket joint, and the surfaces are covered in articular cartilage. This cartilage may be damaged by wear and tear, inflammation, and previous injury. Damaged cartilage causes severe shoulder pain and decreased mobility referred to as shoulder arthritis. Several conditions lead to this cartilage damage and shoulder arthritis, including osteoarthritis (degenerative joint disease), rheumatoid arthritis (inflammatory arthritis), and more rarely arthritis caused by severe shoulder injury. Shoulder replacement surgery can provide pain relief and improved mobility in patients who have not experienced relief from previous attempts to reduce persistent shoulder pain.
For patients who have exhausted other options to relieve shoulder arthritis, Dr. Shani replaces the damaged ball-and-socket joint of the shoulder with artificial components (prostheses) in a procedure called Total Shoulder Replacement surgery. After moving aside the muscles in the shoulder, Dr. Shani anchors a stem attached to a polished metal ball into the upper arm bone. This replaces the ball of the shoulder joint. A shallow cup made of high-density plastic is then attached to the shoulder socket to replace the injured socket. This metal ball rests in the shallow plastic cup, completely replacing the injured shoulder joint. Total Shoulder Replacement surgery has shown good results in returning full range of motion to the shoulder and reducing pain.
Reverse Shoulder Replacement surgery is necessary for patients with advanced rotator cuff tear arthropathy, a condition where the rotator cuff muscles have weakened to the point that they no longer hold the shoulder in place or allow it to function normally. This surgery reverses the natural position of the ball and the socket in the shoulder joint by replacing both parts with artificial components (prostheses). In this highly technical procedure, Dr. Shani anchors a metal stem attached to a shallow cup made of high-density plastic into the upper arm to replace the ball of the shoulder joint. A polished metal ball is anchored into the original position of the shoulder socket. The new placement of these artificial components reverses the natural position of the shoulder and allows the deltoid muscles to do the work of the weakened rotator cuff. The reversed shoulder can regain near natural mobility.
Rehabilitation for Shoulder Replacement Surgeries takes about six months. Patients work with Dr. Shani and physical therapist on individualized rehabilitation programs to regain full shoulder mobility. These orthopedic-surgery require a hospital stay of one to three days. The day after surgery, the shoulder is moved gently with a physical therapist. The arm is kept in a sling for at least three weeks. After two months physical therapy focuses on the moderate strengthening of the shoulder, and after three months shifts focus to the advanced strengthening of the shoulder. Most patients return to pre-injury levels of play and activity after six months of physical therapy and consultations with Dr. Shani.