Shoulder replacement is a shoulder pain treatment for severe pain and stiffness that typically results from arthritis or injury of your shoulder joint.

The procedure may also be performed in patients who have:

• long term rotator cuff tear – tear of the muscles and tendons that surround your shoulder joint and keep the head of your upper arm bone in your shoulder socket. A torn rotator cuff can cause osteoarthritis.
• frozen shoulder – an inability to move your shoulder as the shoulder capsule of connective tissue thickens and becomes tight. Stiff bands of tissue, called adhesions, may develop.
• shoulder bone spurs – bone spur shoulder is an abnormal bony overgrowth of your normal bone that often occurs with osteoarthritis.
• avascular necrosis - a lack of blood supply to your upper arm bone causes it to die and can lead to breaks in your bone and eventually bone collapse. It can cause osteoarthritis to develop.

Arthritis of the shoulder is a condition that damages the smooth and lubricated shoulder joint cartilage, that would normally allow the ends of your shoulder joint bones to glide easily. The most common types of arthritis of the shoulder are:

• osteoarthritis - a wear and tear condition that causes your shoulder joint to become stiff and painful. It occurs when the shock-absorbing cartilage that cushions your shoulder joint becomes inflamed, worn away and eventually lost, and when you move your shoulder joint, the bones of the joint then rub against each other and cause pain. It is one of the most common reasons why patients need shoulder replacement surgery.
• rheumatoid arthritis (RA) - a chronic autoimmune disease that causes your immune system to attack and damage normal tissue such as cartilage and ligaments. It usually affects both of your shoulder joints.
• posttraumatic arthritis - a form of osteoarthritis that develops after an injury, such as a shoulder fracture or dislocation.

Total shoulder replacement surgery typically takes around two hours and can be performed under general or local anaesthetic.

Your surgeon will make an incision down the front of your shoulder to allow access to your shoulder joint. They will remove your arthritic ball (humeral head) and carefully prepare your bone surfaces to accept the components of your new shoulder. A highly polished metal ball is inserted into place using cement or implants that foster bone ingrowth and, a new smooth plastic surface is press-fitted or cemented on to your glenoid, also called the socket.

Your incision will then closed using stitches that will need removing after two weeks.

Procedure alternatives include a partial shoulder replacement (or hemi-replacement) where only the ball is replaced, leaving the glenoid socket untouched and, shoulder resurfacing whereby a metal covering or cap is placed on your humeral joint surface and your humeral bone is preserved.

Shoulder replacement surgery will only be recommended if other treatments such as physiotherapy, non-steroid anti-inflammatory medicines, steroid injections and shoulder arthroscopy haven’t worked for you.

Possible complications of any operation include: wound infection, an unexpected reaction to the anaesthetic, excessive bleeding or a blood clot.

Complications specific to total shoulder replacement surgery:

• shoulder instability - the top of your upper arm moves out of its socket.
• accidental damage to your shoulder joint - nerves, muscles and blood vessels.
• joint infection.
• small bone cracks leading to a fractured shoulder bone.
A new shoulder joint should last for at least ten years. If necessary it can then be replaced again.

If you decide to pay for your treatment, Ramsay offer an all-inclusive Total Care package, where a single one-off payment at a pre-agreed price, delivering direct access to all the treatment you need for complete reassurance. You can also spread the cost of your treatment with finance options available.

A total shoulder replacement may be covered by your medical insurance policy. We advise you to check directly with your insurance provider and get written confirmation before commencing treatment.

Following your shoulder replacement surgery, you will stay in hospital for up to four days.

One of our physiotherapists will offer support and advise on a physiotherapy and exercise plan the day after your surgery until you leave hospital. You should continue with these exercises for many months to aid your recovery and ensure you regain maximum movement, strength and power.

Your arm will be kept in a sling for around four weeks.

Most patients can drive again after six to eight weeks when they have regained good use of their shoulder.

It usually takes at least three months to make a full recovery from total shoulder replacement surgery, but this does vary from patient to patient, so make sure you follow your surgeon’s advice. You should ask their advice on lifting, returning to work and other activities.

Many patients return to the sports and lifestyle they love following shoulder replacement surgery.

Ramsay Health Care Hospitals provide you the very best of care and all the support you need before, during and after your shoulder surgery. Our leading shoulder surgeons, orthopaedic nursing staff, consultant radiologists and chartered physiotherapists will develop and plan your individual treatment plan.

Our aim is to manage your shoulder pain and provide fast, efficient and appropriate diagnosis and treatment to alleviate your pain and improve your mobility, allowing you to quickly return to the activities you love and, regain a better quality of life.

Tees Valley Hospital Specialists

Professor Paul Baker

Professor Paul Baker is a Consultant Orthopaedic Surgeon in Middlesborough, who specialises in hip and knee surgery
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Mr Tim Brock

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Mr Chris Coapes

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Mr David Elson

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Mr Andrew Gray

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Mr Philip Holland

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Mr Anwar Jafri

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Mr Richard Jeavons

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Mr Ian McMurtry

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Mr Rajesh Nanda

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Mr Ramsay Refaie

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