Arthritis of the shoulder is much less common than arthritis of the knee or hip. When evaluating patients with shoulder arthritis the first consideration is the condition of the rotator cuff. This is a group of tendons that envelop the ball of the shoulder joint and is necessary for normal shoulder function. If there is evidence of a rotator cuff tear on physical exam or patients have had a previous rotator cuff repair, an MRI to fully evaluate the rotator cuff tendons is helpful. Depending on the integrity of the rotator cuff, one of two surgical options exist for treatment of shoulder arthritis.
Total Shoulder surgery involves replacement of the joint surface with an artificial ball and socket and is very similar in concept to a total hip replacement. The surgery is performed through a 4-5 inch incision over the front of the shoulder. Both the humeral surface (ball) and the glenoid surface (socket) are typically replaced to give patients the maximal pain relief from the surgery. The repair of the rotator cuff tendons over the prosthesis is critical to achieving a good outcome. Most patients stay 1-2 days in the hospital and are discharged with a sling for comfort. Unlike hip and knee arthroplasties, blood clots after shoulder surgery are uncommon, and the use of blood thinners is not standard. Most patients leave the hospital with less pain in their shoulder than before surgery. Recovery involves a fairly intensive physical therapy program over 3-6 months to achieve full function.