When conservative methods of treatment fail to provide adequate relief of pain and loss of use of the shoulder/arm, a total arthroplasty or hemi arthroplasy is considered. Development of the total shoulder replacement began over 40 years ago and over 15,000 people each year under go this surgery to reduce pain and stiffness and restore mobility. Shoulder replacement requires an individualized rehab program.
Unlike knee and hip replacement surgery, a major tendon needs to be divided to access the shoulder joint. In addition the shoulder is the most unstable joint in the body and therefore the rehabilitation plan will decrease pain, improve range of motion, prevent, prevent stress on the repaired tendon and help improve strength. Two broad procedures for shoulder replacements include hemi arthroplasty and total shoulder arthroplasty. If the surgeon only uses the metal humeral components (upper arm) then the procedure is called a hemi arthroplasty. If the surgeon uses both humeral and glenoid components (shoulder blade socket) then its called a total shoulder arthroplasty.
The primary purpose of the total shoulder replacement is to relieve pain. The secondary purpose is to increase ROM. The extent of improvement in your ROM will depend on the severity of your preoperative condition, the length of time you have had the problem, the ROM of your shoulder before surgery and your commitment to preoperative and post operative rehab programs.
The postoperative rehabilitation program is critical and it is important that you cooperate with your physical therapist, follow your surgeons instructions and work hard. The physical therapist will move your arm and shoulder through various positions to regain range of motion. Your program will be progressed over time to include progressive strengthening and stabilization activities. These movements and exercises will help prevent stiffness, regain shoulder motion and improve strength.
Total joint replacement is a remarkably successful operation that has transformed the lives of many people. Many of those who suffered from severe pain and stiffness in the joint are again swimming, golfing, playing tennis and have resumed their regular activities without pain.
Lianne Flinn, PT
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