Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

Total Shoulder Arthroplasty

FAQs on Total Shoulder Arthroplasty in Gilbert, Chandler, Mesa AZ

 

About 50,000 total shoulder arthroplasty procedures are performed by US surgeons every year. First introduced in 1950s, the surgery is an effective way to treat arthritis, pain, or damage in the shoulder joint. Osteoarthritis accounts for over three-fourth these surgeries performed today while about two-third of patients are over 65 years of age.

What is total shoulder arthroplasty?

Total shoulder arthroplasty is the surgical reconstruction of the shoulder joint. It replaces surfaces of both bone ends at the joint with prostheses. A metal ball with stem is fixed to the harm bone to replace the humeral ball while a plastic component takes the place of the glenoid socket.

The shoulder joint is ball-and-socket formation. The humeral head is fitted into the glenoid or shoulder blade socket. A fibrous band of tissue called cartilage covers the surfaces of both bones and cushion them when they slide against each other. When this cartilage is damaged the bones rub against each other causing the joint stiff and painful.

Aimed at relieving pain and disability caused by irreversible cartilage and bone damage, the total shoulder reconstruction replaced the damaged cartilage by resurfacing and restructuring of both bone ends. The reconstruction improves the shoulder joint range of motions and allows its smooth functioning.

What are conditions treated with total shoulder arthroplasty?

Total shoulder arthroplasty is a viable treatment for damage to the glenohumeral joint due to the following conditions.

  • Osteoarthritis or cartilage wear and tear damage, mostly in people above 55 years
  • Rheumatoid arthritis or chronic synovial membrane inflammation prevents lubrication of the cartilage and contributes to its loss and stiffness.
  • Post-traumatic arthritis caused by cartilage damage due to injury to the shoulder.
  • Rotator cuff tear arthropathy leading to cartilage destruction
  • Avascular necrosis or damage to the shoulder joint due to lack of adequate blood supply
  • Sever fracture damaging the arm bone
  • Failure of the previous partial shoulder surgery

Who is a candidate for total shoulder arthroplasty?

The presence of arthritis or similar conditions does not automatically qualify total shoulder replacement. The condition must be serious enough and cannot be controlled using other pain management methods. Orthopaedic surgeons suggest the procedure when

  • the shoulder pain is severe enough to cause disability in performing routine activities and impact the quality of life
  • no improvement despite using all nonsurgical options
  • pain symptoms continue to exist for a long time
  • significant shoulder weakness and loss of motion

How is total shoulder arthroplasty performed?

The surgery is performed under general anesthesia. Patient is kept on a beach chair semisitting position and his shoulder is placed on the operating table. Surgeons access the shoulder by making incisions on the front or side. The deltoid and pectoral muscles are separated and the rotator cuff is opened.

Surgeons resurface or remove the damaged humeral head depending on its condition. A ball-shaped metal head with a stem is fixed to the arm bone. The glenoid depression is also resurfaced and attached with a plastic socket. Both implants are fixed to the surrounding muscles, bones, and tendons using cementing, press fitting, grafting, or bone ingrowth technique.

Now the ball and socket joint is reconstructed and incision is closed.

How long does total shoulder arthroplasty surgery take?

The surgery takes around 2 hours.

Do I need to stay at the hospital after total shoulder arthroplasty?

Patients should stay in the hospital for 2 to 3 days and are discharged after their condition stabilizes. Total shoulder arthroplasty is an inpatient procedure and requires shoulder rest for 2 weeks.

What are the restrictions following total shoulder arthroplasty?

  • Keep the operated area clean and dry
  • No shower for 4 days
  • Complete shoulder rest for a week
  • Use a sling for 6 weeks
  • Begin physical therapy after a week
  • Avoid forced shoulder muscle contractions until the sixth week
  • No extreme arm positions for 6 weeks
  • No driving for 6 weeks
  • No overhead shoulder motion for 6 to 8 weeks
  • Don’t overdo forceful shoulder muscle contractions for 6 weeks
  • No lightweight lifting for 6 weeks
  • Complete bar on weightlifting or high-impact sports after shoulder reconstruction
  • No driving or overhead activities for 6 weeks

What kind of rehabilitation is needed following total shoulder arthroplasty?      

  • Day 1 to 7: Gentle soft tissue massage, passive motions, no stress on the shoulder
  • Week 2 to 4: Continue wearing a sling and do elbow and wrist workouts, avoid shoulder AROM, exercises to maintain shoulder joint integrity, avoid shoulder extension, do deltoid isometrics, , etc.
  • Week 4 to 6: Progressive PROM, minimal resisted elbow, wrist, and hand workouts, cryotherapy, scapular forward flexion and elevation, progressive isometrics, etc.
  • Week 6 to 12: Start shoulder AROM, increased PROM, dynamic shoulder and scapular stability activities, scapular forward flexion and elevation, strengthen elbow, wrist, and hand, gentle glenohumeral isometrics, etc.
  • Week 12 to 4 Months: Enhanced functional workouts, shoulder and muscular endurance workouts. No lifting or pushing.
  • After 4 Months: Continue structural and functional strength gains

How long is the recovery period following total shoulder arthroplasty?

Within six week, patients gain shoulder strength and perform regular activities thereafter. The reconstructed shoulder achieves its optimal level in 6 to 8 months. However, the result is mostly related to pain relief and range of motions. It should not be subject to excessive stress, high impact, or heavy loads, as these may lead to early implant failure.

What are the potential complications of total shoulder arthroplasty?

  • Surgical complications, such bleeding, swelling, temporary stiffness, and pain, that go after a few days.
  • Hardware failure considerably earlier than expected
  • Anesthesia complications
  • Nerve injury and infections due to surgical mistakes

References

Kim SH, Wise BL, et al. Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am. 2011 Dec 21; 93(24):2249-54

Haines JF, Trail IA, et al. The results of arthroplasty in osteoarthritis of the shoulder. J Bone Joint Surg Br. 2006 Apr; 88(4):496-501.

Matsen, F.A., III, Antoniou, J., et al. Correlates with comfort and function after total shoulder arthroplasty for degenerative joint disease. J. Shoulder Elbow Surg., 9(6):465-469, 2000

Goldberg, B.A., Smith, K.L., et al. The magnitude and durability of functional improvement after total shoulder arthroplasty for degenerative joint disease. J. Shoulder Elbow Surg., 10(5):464-469, 2001.

Wilcox R, Arslanian L, Millett P. Rehabilitation following total shoulder arthroplasty. The Journal of Orthopaedic and Sports Physical Therapy. December 2005;35(12):821-836

Keller J, Bak S, et al. Glenoid replacement in total shoulder arthroplasty. Orthopedics. March 2006;29(3):221-226.

Wiater J, Fabing M. Shoulder arthroplasty: prosthetic options and indications. The Journal of The American Academy Of Orthopaedic Surgeons. July 2009;17(7):415-425.

Barrett W, Franklin J, Jackins S, Wyss C, Matsen F. Total shoulder arthroplasty. The Journal of Bone and Joint Surgery. July 1987;69(6):865-872.

Collins D, Harryman D, Wirth M. Shoulder arthroplasty for the treatment of inflammatory arthritis. The Journal Of Bone And Joint Surgery. November 2004;86-A(11):2489-2496.

Boardman N, Cofield R, at al. Rehabilitation after total shoulder arthroplasty. The Journal of Arthroplasty. June 2001;16(4):483-486.

Figgie HE, Inglis AE, et al: Analysis of factors affecting the long term results of total shoulder arthroplasty in inflammatory arthritis. J Arthroplasty 3:123-30, 1988

 

 

 

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