Shoulder Replacement Surgeon
Are you suffering from shoulder arthritis? If so, you may be a candidate for a shoulder replacement. Shoulder replacement surgery is a viable option for patients suffering from arthritis who have exhausted all non-surgical and more minimally invasive surgical options. Shoulder replacement surgeon, Dr. Robert Boykin provides diagnosis and both surgical and nonsurgical treatment options for patients in Asheville who have developed shoulder arthritis. Contact Dr. Boykin’s team today!
Osteoarthritis of the shoulder can cause weakness, stiffness, and for many, debilitating pain. It often affects the older adult population and is the result of the natural aging process, wear and tear, and for some, the ongoing degeneration of the joint following a previous injury. It can take years for the disease process to advance to a level that leads to pain severe enough to warrant replacement surgery. However, once all non-operative and joint preserving options have been exhausted, replacement surgery is often recommended and has a proven tract record for improving pain and restoring function. Shoulder surgeon, Dr. Robert Boykin specializes in shoulder replacement surgery for patients in Asheville, Arden and Fletcher, North Carolina.
What is a Shoulder Replacement?
Shoulder replacement surgery, also known as total shoulder arthroplasty, has changed the lives of thousands of patients who suffer from chronic shoulder pain and osteoarthritis. A joint replacement procedure (arthroplasty) is a surgery that replaces the ends of the bones of the damaged joint. During the procedure, the degenerated cartilage and bone of the shoulder joint are replaced with metal and plastic components. These components allow for a smooth, pain free motion of the joint. If a patient has experienced severe rotator cuff injuries that led to the arthritis, a reverse total shoulder replacement approach will be recommended over the traditional shoulder replacement surgery.
Is a Shoulder Replacement Right for Me?
It’s important to note that replacement surgery is not for everyone. While it often brings relief for patients and promising results, the replacement does not last forever. Although it is hard to predict how long the modern replacements will last, it is thought that a total shoulder arthroplasty will last on average between 15-25 years. In some patients this may be longer and in others less depending on the activity level of the patient and a number of other factors. For this reason, the procedure is typically recommended for patients who are 65 years of age and older. Special considerations are made for younger patients with osteoarthritis, although a joint preserving surgery is usually recommended first in younger age groups.
Recovery Following a Shoulder Replacement
Shoulder replacement surgery will require physical therapy so that the shoulder joint can regain strength, range of motion, and overall mobility. Initial rehabilitation with a qualified physical therapist will focus on safe motion with certain restrictions for 6 weeks. A sling is usually worn for a total of 6 weeks after surgery. After a recovery period of 2-3 months, patients note significant relief of their pain and are able to get back to performing their normal activities.
Total (Anatomic) Shoulder Arthroplasty (Replacement) FAQ
When is anatomic total shoulder surgery necessary?
Patients suffering from advanced shoulder osteoarthritis and have tried non-operative shoulder treatments without relief from pain and stiffness in the shoulder may be candidates for total shoulder arthroplasty.
How long is the surgery for total shoulder replacement and how long is the hospital stay?
A typical anatomic total shoulder replacement takes about two hours to perform. Some patients may be candidates to go home that same day, however the majority of patients spend one night in the hospital and are discharged the next day.
How successful is a total shoulder replacement?
The vast majority of anatomic shoulder replacement surgeries are successful with long term follow-up data to support their longevity. Patients typically note improvement in pain and function. An anatomic shoulder arthroplasty is able to generally provide improved range of motion as compared to a reverse total shoulder.
What are the alternatives to total shoulder replacement?
For younger patients who are not quite ready for a total shoulder replacement, Dr. Boykin can offer joint preservation and cartilage restoration for the shoulder. In select patients, cartilage restoration uses donated tissue to regrow joint tissue. The damaged tissue is replaced with healthy cartilage from either the patient’s own body or a donor cadaver. This procedure biologically restores the joint.
Another procedure, known as the CAM (Comprehensive Arthroscopic Management) procedure uses a variety of arthroscopic surgical joint preserving techniques to remove loose cartilage and labral tissue and to smooth out and reshape the joint. The success rate for this surgery is high and most young athletes that have this surgery can return to their activities after recovery.
How long does it take to fully recover from total shoulder replacement surgery?
After careful participation on Dr. Boykin’s recovery protocols, patients can expect improvement is pain and function around 3 months after surgery Most patients return to sporting activities in about six months.
What is the difference between a total shoulder replacement and reverse shoulder replacement?
A standard anatomic total shoulder arthroplasty involved replacing the worn-out ball and socket with a new metal ball and high strength plastic socket that matches the patient’s normal anatomy. These replacements rely on the rotator cuff muscles to be functioning to provide power and stability to the shoulder. These are most commonly performed in patients with advanced osteoarthritis or rheumatoid arthritis who have an intact rotator cuff. Unlike a standard shoulder replacement, reverse shoulder replacement surgery relies on the deltoid muscle for stability and mobility. Since the deltoid muscle is rarely torn, it provides a reliable source of power and stability for those patients who have a torn rotator cuff. The reverse replacement involves placing a metal ball where the socket normally is and a plastic socket when the ball normally is (the shoulder is actually reversed). This changes the center of rotation of the shoulder and allows the deltoid muscle to provide power to the shoulder.
Is shoulder surgery replacement major surgery?
A total shoulder replacement is a larger operation than arthroscopic surgery and Dr. Boykin usually recommends a one-night hospital stay. Oral pain medication can be prescribed to help ease discomfort and should be taken as directed. Pain in the hospital will be managed by Dr. Boykin and the anesthesia team. Rehabilitation is started right away, usually on the day of surgery. After hospital discharge, the arm will be in a sling for 5- 6 weeks total.
What is the difference between total shoulder replacement and rotator cuff repair?
Total shoulder replacement replaces the damaged shoulder joint with artificial implants. Shoulder joint replacement is usually performed when the joint is severely damaged by osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, rotator cuff tear arthropathy, avascular necrosis or failed former shoulder surgery.
The rotator cuff is a is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the socket of the shoulder and provides power to the shoulder. Rotator cuff surgery repairs a torn rotator cuff (leaves the actual joint alone) and can usually be done on an outpatient basis through an arthroscopic approach.
How long do you have to wear a sling after total shoulder replacement surgery?
A sling is used after a total shoulder replacement to keep the arm and shoulder immobile and to allow the repair to heal properly. Dr. Boykin will have the patient begin home therapy right away followed by outpatient physical therapy at 2 weeks and come of the sling at 6 weeks after surgery.
What does a total shoulder replacement scar look like?
Total shoulder replacement is an open surgery, requiring a single larger incision than arthroscopic surgery. Dr Boykin and his team are careful to minimize scaring and try to leave only a small scar which is typically 3-5 inches in length.
What can I expect after shoulder replacement and airport security?
Shoulder replacement surgery uses plastic and metal parts. On occasion, the metal can set off a security scanner at the airport. Patients only need explain to the TSA that they have had a total shoulder replacement. Often the area is examined with a wand or a pat-down and further investigation is unnecessary. Cards or paper to prove that the patient has had surgery are no longer accepted by the TSA.
What happens when a shoulder replacement fails?
If a shoulder implant wears out, or does not function properly, Dr. Boykin will conduct a thorough investigation to determine the underlying cause for this. In some cases a conversion to a procedure called reverse shoulder replacement surgery may be needed. This surgery has been proven to help patients who have had a prior failed total shoulder replacement.
For more information on the treatment of osteoarthritis of the shoulder, or to learn more about shoulder replacement surgery, please contact the office of Dr. Robert Boykin, orthopedic shoulder surgeon and sports medicine specialist serving Asheville, Arden, Fletcher and surrounding North Carolina communities.