Shoulder Replacement

The shoulder is a ball and socket joint. This joint is the most mobile in the body and because of this it is inherently unstable. The head of the upper arm bone is the ball. It fits into the shallow glenoid socket in the shoulder blade. The ends of the bones are covered with articular cartilage which enables easy movement and protects the bones. The joint is surrounded by muscles and tendons (rotator cuff) which hold the shoulder bones in place and provide stability and support.

• A partial shoulder replacement (hemiarthroplasty) may involve replacing only the damaged ball or resurfacing the ball to preserve healthy bone. A resurfacing hemiarthroplasty involves replacing the surface of the ball with a prosthetic cap. A hemiarthroplasty involves replacing the ball and the stem which articulates in the natural socket.
• Anatomic total shoulder replacement arthroplasty (TSA) is the procedure to treat a severely arthritic or severely injured shoulder. It involves a replacement of both the ball and the socket. TSA is the gold standard treatment for patients with osteoarthritis of the shoulder joint who have an intact rotator cuff. TSA patients can expect a significant and lasting improvement in pain, range of motion and function.
• A stemless anatomic total shoulder arthroplasty is used in the treatment of osteoarthritis of the shoulder joint and for other degenerative shoulder diseases. It provides similar functional outcomes and complication rates when compared to stemmed TSA, but with reduced operative time and lower blood loss and greater bone preservation.
• Reverse shoulder replacement (RSA)is surgery to replace the ball and socket, but the ball is attached to the shoulder and the socket becomes part of the upper arm bone. This procedure is beneficial for people with:

• • irreparable massive rotator cuff tears
  • chronic shoulder dislocation
  • complex fractures in the shoulder joint
  • a prior failed shoulder replacement
  • chronic pain that has not improved with other treatments

The choice of type of shoulder replacement is determined by the amount of healthy bone, soft tissues, tendons, and rotator cuff.

During your consultation with Dr. Petrigliano, he will inquire about your symptoms, review your medical history, conduct a physical examination, and evaluate your range of motion and the source of your pain. He will order imaging studies including a CT scan and/or an MRI to evaluate the bones and soft tissues; and x-rays to view the damage to joint surfaces, bone spurs, and fractures to determine whether the problems causing your symptoms can be fixed or the shoulder must be replaced. Dr. Petrigliano will create a personalized treatment plan to address you needs, and work with you and your family to determine next steps.