The Total Joint Center
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Total Joint Center Physicians
Shoulder replacement surgery was first introduced in the 1950s to treat severe shoulder fractures. Since that time, there has been extensive innovation in shoulder replacement, as well as expansion in the indications for the procedure. Shoulder replacement is most commonly performed to treat degenerative joint disease (osteoarthritis) and has been highly successful in relieving pain and restoring function. It is also used to treat severe rotator cuff tears, rheumatoid arthritis, posttraumatic conditions, and avascular necrosis, among other problems.
The shoulder girdle is comprised of three bones including the humerus (arm bone), scapula (shoulder blade), and clavicle (collarbone), as well as numerous muscles. The shoulder joint (glenohumeral joint) is a ball-and-socket joint made up the humeral head (ball) and glenoid (socket). Because the humeral head is much larger than the glenoid (like a golf ball on a tee) the shoulder is highly dependent on soft tissues (rotator cuff, labrum, capsule and ligaments) for stability.
The shoulder is the most mobile and least stabile large joint in the body. This allows the shoulder to have extensive motion to support function of the hand and upper extremity. In addition the smooth articular cartilage on the humerus and glenoid allows almost frictionless motion of the shoulder joint.
The rotator cuff, a group of four muscles and tendons that extend from the scapula to the humerus to the scapula and surrounding the shoulder joint are extremely important for normal shoulder motion, strength and function.
The majority of patients undergoing shoulder replacement surgery-those with little or no damage to the rotator cuff-benefit from traditional total shoulder replacement, in which a plastic component resurfaces the glenoid (socket) and a metal implant replaces the damaged humeral head (ball), mimicking the natural anatomy of the shoulder joint.
For patients who suffer from severe arthritis combined with a torn rotator cuff, the standard replacement surgery may not be adequate. A more recent procedure called reverse total shoulder replacement changes the structure so that the socket and ball are switched. A metal ball is placed onto the scapula and the socket is placed at the top of the humerus. Movement relies on the stronger deltoid shoulder muscle, offering pain relief combined with functional restoration for these patients.
In addition, some severe proximal humerus fractures that cannot be fixed can be treated with traditional or reverse total shoulder replacements.
The Total Joint Center has surgeons with vast experience performing all types of shoulder replacement surgery, from the simplest and least invasive to the most complex. In addition, they are leaders in the development of new shoulder replacement techniques and are internationally recognized for their research and for educating other shoulder surgeons throughout the world.
See also: reverse total shoulder replacement.