Shoulder arthroplasty has evolved dramatically over the last few years. It is possible to restore good shoulder function and pain relief in a safe and reliable fashion with minimal hospital stay.
Broadly speaking, shoulder replacement is of one of the three types –
1. Hemi arthroplasty (Partial)
2. Total shoulder replacement
3. Reverse shoulder replacement
Hemi arthoplasty of the shoulder is usually considered for those cases with severe damage to one side of the joint (humeral head). This is seen in complex humeral head and neck fractures, especially in the elderly, where fixation may not be a viable option.
Total shoulder replacement is considered for those patients who have cartilage damage to both sides of the joint (humeral head and glenoid). Severe arthritis is the commonest indication.
Reverse shoulder replacement is indicated in cases with joint degeneration without a functional rotator cuff. It is also occasionally indicated for certain severely comminuted fractures of the shoulder in the elderly where the outcome of fixation is anticipated to be poor. The design of the prosthesis is such that it compensates for the torn or dysfunctional rotator cuff by altering the biomechanics of the shoulder. This enables the patients to recover most of their shoulder movement without pain, despite the cuff not functioning.
