Glenohumeral (shoulder) joint arthritis occurs when the protective cartilage on the surface of the glenoid (socket of the shoulder joint) and the humeral head (ball of the shoulder joint of the upper arm) wears out.
As the cartilage breaks down, the worn ends of the bones can grind together, deform, and cause inflammation, shoulder pain, and physical limitations. When symptoms warrant, a total shoulder arthroplasty (TSA) may be recommended.
What Is Total Shoulder Arthroplasty?
Total shoulder arthroplasty is a procedure used to replace the worn surfaces of the shoulder joint.
Dr. Chudik makes a limited incision over the front of the shoulder and works through intervals in the shoulder and chest muscles so he can resurface the humerus (ball) and the glenoid (socket).
The worn surfaces are replaced with metal and special plastic components that are fit to the patient’s shoulder.
Who Is a Candidate?
Total shoulder arthroplasty may be recommended when shoulder arthritis causes symptoms significant enough to warrant surgery.
Shoulder arthritis can develop as the protective cartilage wears down because of genetic susceptibility, excessive joint loading over time, or following injury.
Surgery may not be appropriate in the presence of:
- Infection
- Poor general health that is not sufficient to proceed with surgery
- An inability or unwillingness to complete the postoperative program, including wearing a sling for six weeks and participating in physical therapy two to three times per week for four months
How the Procedure Is Performed
Total shoulder arthroplasty may be performed as outpatient surgery or with a 23-hour overnight stay. General anesthesia with an interscalene nerve block is used.
Dr. Chudik makes a limited incision over the front of the shoulder and works through intervals in the shoulder and chest muscles.
The worn surfaces of the humerus (ball) and glenoid (socket) are resurfaced and replaced with metal and special plastic components that are fit to the shoulder.
Recovery and Rehabilitation
Following surgery:
- A sling is worn at all times except for bathing, dressing, and exercises for six weeks, including while sleeping.
- The replaced shoulder should not be actively moved using its own shoulder muscles for at least six weeks in order to protect the rotator cuff and allow it to heal.
- Patients may feel more comfortable sleeping upright on a couch or recliner after surgery.
- The wound should remain clean and dry for 10 to 14 days following open shoulder surgery.
- Light showering may begin after 14 days, but the wound should not be submerged under water for three weeks.
- Driving may resume after six to eight weeks.
- Patients may return to school or sedentary work in less than one to two weeks as long as the arm remains in the sling and is not used.
- Physical therapy should begin two to three days after surgery and continue for four months.
The success of a total shoulder arthroplasty is highly dependent on postoperative rehabilitation, making it important to follow and maintain the prescribed therapy schedule.
Patients may return to activities when rehabilitation is complete and functional use has been restored. Usually four to six months is necessary after total shoulder arthroplasty before returning to activities. Full shoulder motion and strength are necessary before returning to activities.
Dr. Chudik also has special protocols for returning to golf.
Risks and Outcomes
Potential surgical risks and complications include:
- Infection
- Bleeding
- Rare injury to nerves of the shoulder and arm, which may cause numbness, weakness, or paralysis
- Persistent stiffness or loss of shoulder motion
- Loosening of the prosthesis, particularly the glenoid implant
- Moving or breaking of surgical hardware
- Need for revision surgery
Return to activities generally depends on completion of rehabilitation and restoration of functional use, shoulder motion, and strength.
Why Dr. Chudik for Total Shoulder Arthroplasty
Dr. Chudik performs total shoulder arthroplasty through a limited incision over the front of the shoulder and works through intervals in the shoulder and chest muscles to resurface the humerus and glenoid.
The worn joint surfaces are replaced with metal and special plastic components that are fit to the patient’s shoulder. Dr. Chudik also provides a structured postoperative rehabilitation program and has special protocols for returning to golf. minimizing soft-tissue disruption and preserving the rotator cuff. For appropriate younger patients, Dr. Chudik also offers joint-preserving alternatives including the Arthroscopic Biologic Total Shoulder Resurfacing technique he developed.