Am I a Candidate for Shoulder Replacement?

What is Shoulder Replacement?

Shoulder replacement is a surgical procedure where the damaged parts of your shoulder are removed and replaced with artificial parts known as prostheses.

The shoulder is a ball-and-socket joint made up of three bones; the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). The ball at the top of the upper arm bone fits neatly into a socket, called the glenoid, which is part of the shoulder blade. The surfaces of the bones where they touch are surrounded with articular cartilage, a smooth substance that protects the bones and allows them to move smoothly against each other. If your cartilage is damaged by wear and tear, injury, or arthritis, it can make your shoulder joint stiff and painful necessitating shoulder replacement.

What are the Types of Shoulder Replacement?

Shoulder replacement surgery restores the ball and sometimes the socket with an artificial part or prosthesis. There are different types of shoulder replacement, including:

• Total Shoulder Replacement (Traditional Shoulder Arthroplasty): This procedure involves replacing both the damaged ball-and-socket surfaces of the shoulder with similarly shaped prosthetics.
• Partial Shoulder Replacement (Stemmed Hemiarthroplasty): This procedure involves partially replacing the damaged shoulder’s parts where only the humeral head is detached and replaced with a prosthetic ball instead of replacing both the socket and ball with prosthetics.
• Reverse Shoulder Replacement (Reverse Total Shoulder Arthroplasty): This procedure involves reversing the position of the shoulder joint’s ball and socket. The ball at the top of the upper arm bone is replaced with a socket-shaped prosthetic, while the shoulder’s natural socket is fitted with a prosthetic ball.
• Shoulder Resurfacing (Resurfacing Hemiarthroplasty): This surgery involves fitting the damaged humeral head with a rounded smooth cap to enable better joint movement.

What are the Indications for Shoulder Replacement?

Some of the indications that prompt shoulder replacement surgery include:

• Torn rotator cuff
• Osteoarthritis
• Serious shoulder injury or fractures
• Persistent pain that interferes with everyday activities
• Moderate to severe pain while resting
• Loss of motion and/or weakness
• Avascular necrosis
• Rheumatoid arthritis
• Failed previous replacement surgery
• Posttraumatic arthritis
• Failure to considerably improve with conservative treatments, such as physical therapy, anti-inflammatory medications, or cortisone injections

Am I a Candidate for Shoulder Replacement Surgery?

Whether or not you are a suitable candidate for shoulder replacement surgery would depend upon the evaluation and assessment of the indications, symptoms, and medical history; your response to conservative treatment; and your answer to the shoulder replacement questionnaire mentioned below:

• In general, your pain can be described as: 
  • Mild but does not affect movement
  • Moderate and some difficulty with movement
  • Severe and great difficulty with movement
  • Extremely severe and certain movements are impossible 
• Does your shoulder pain affect your sleep? 
  • Never
  • Sometimes
  • Mostly
  • Every night 
• Are you able to perform your basic household functions? 
  • Yes, with very little difficulty
  • I cannot perform certain tasks
  • I can only perform some tasks
  • I am mostly dependent on others 
• Do you feel your shoulder is unstable or may give way? 
  • No
  • Sometimes
  • Often
  • Always 
• While working, how long does it take before you experience severe shoulder pain? 
  • More than half an hour
  • 15-30 minutes
  • 5-15 minutes
  • Less than 5 minutes or instant pain with walking 
• Could you brush or comb with the affected shoulder? 
  • Yes, with little difficulty
  • Yes, with some difficulty
  • Sometimes I can’t
  • Most of the time I can’t 
• After sleeping for a long time, describe the pain you experience on trying to get up post waking up? 
  • Mild, with little difficulty getting up
  • Moderate, with some difficulty getting up
  • Severe, with great difficulty getting up
  • Extremely severe, requiring assistance to get up 
• Have you been able to wash and dry yourself under both arms? 
  • I can with no difficulty
  • I can with some difficulty
  • I can but it’s very difficult
  • Impossible 
• While driving, entering and exiting a car or using other forms of transport, your shoulder pain is described as:
  • Mild
  • Moderate
  • Severe
  • Extremely severe 
• Could you hang your clothes up in a wardrobe? 
  • I can with no difficulty
  • I can with some difficulty
  • I can but it’s very difficult
  • Impossible 
• Could you carry a tray containing a plate of food across a room? 
  • I can with no difficulty
  • I can with some difficulty
  • I can but it’s very difficult
  • Impossible 
• How much has pain in your shoulder interfered with your work, hobbies, or recreational activities?
  • Mild
  • Moderate
  • Severe
  • Extremely severe 
• Could you do the household shopping on your own? 
  • I can with no difficulty
  • I can with some difficulty
  • I can but it’s very difficult
  • Impossible 
• Have you had any trouble dressing because of your shoulder? 
  • No
  • Sometimes
  • Often
  • Always