Shoulder Replacement Surgery (Total Shoulder Replacement)

Shoulder replacement surgeryis a surgical intervention performed due to severe damage, pain or loss of function in the shoulder joint. It is usually performed to treat pain and movement limitations that develop as a result of cartilage wear or bone damage in the shoulder joint. This surgery involves replacing the damaged shoulder joint surfaces with artificial prostheses.

Reasons for Shoulder Replacement Surgery

Shoulder replacement is usually performed because of the following conditions:

1. Osteoarthritis (Calcification): Wear of the cartilage in the shoulder joint causes the bones to rub against each other and leads to severe pain and restricted movement.
2. Rheumatoid Arthritis: The immune system attacks the tissues in the joint, resulting in inflammation of the shoulder and long-term damage to the joint.
3. Shoulder Fractures and Tears: Fractures in the shoulder can cause permanent damage to the joint. Especially in older people, healing after fractures can be difficult and prosthesis may be recommended.
4. Rotator Cuff Tears: Tearing the rotator cuff muscles in the shoulder can cause pain and restriction of movement in the joint. The tears can be serious enough to require prosthetic surgery.
5. Aseptic Necrosis: The death of bones and increased damage to the joint as a result of impaired blood supply to the shoulder joint may require a prosthesis.
6. Shoulder Instability: Due to disturbances in the natural structure of the shoulder, there may be a loss of stability in the joint.

Symptoms of Shoulder Replacement Surgery

Some of the symptoms that require shoulder replacement surgery are as follows:

• Severe and persistent shoulder pain, even during rest or sleep.
• Limitation of movement in the shoulder, especially difficulty with lifting and rotating movements.
• Pain and inflammation that does not go away with medication or physical therapy.
• Swelling or deformity of the shoulder.
• Lack of functional use of the shoulder, difficulty in daily activities.

How Shoulder Replacement Surgery is Performed

Shoulder replacement surgery usually involves the following steps:

1. Anesthesia: Shoulder replacement surgery can be performed under general anesthesia or regional anesthesia (numbing of the shoulder area). The type of anesthesia to be used depends on the patient's condition and the surgeon's preference.
2. Making the Incision: The surgeon makes an incision in the skin to gain access to the shoulder joint. This incision is usually made on the front or side of the shoulder.
3. Removal of the Damaged Joint: The surgeon removes the damaged parts of the shoulder, especially the head part (humeral head) and the joint socket (glenoid).
4. Placement of the Artificial Prosthesis: The removed parts are replaced with a prosthesis made of metal, plastic or ceramic. The prosthesis is designed to mimic the natural movement of the shoulder.
5. Sewing and Closing: At the end of the surgery, the incision site is closed with sutures and the patient is taken to the recovery room.

Postoperative Recovery

The recovery process after shoulder replacement surgery can vary depending on individual factors, but usually includes the following steps:

• Length of Hospitalization: Patients usually stay in the hospital for 2-3 days after surgery. The recovery time depends on the general health condition of the patient and the technique applied by the surgeon.
• Pain Management: After surgery, patients usually control their pain with painkillers. Initially, pain sensation is normal but decreases over time.
• Physical Therapy: After shoulder replacement, physical therapy is necessary to regain joint mobility and muscle strength. Physical therapy helps patients to move their shoulders and return to their daily activities.
• Walking Aids and Movement Restrictions: After surgery, patients should not move their arms much in the first days. Physical activities are gradually increased.

Risks and Complications of Shoulder Replacement Surgery

As with any surgical intervention, shoulder replacement surgery carries some risks:

• Infection: Infection may develop at the surgical site. It is usually treated with antibiotic therapy, but serious infections may require further surgical intervention.
• Bleeding: Bleeding may occur during or after surgery.
• Clot Formation: There is a risk of blood clots such as deep vein thrombosis (DVT). Blood thinners can be used to reduce this risk.
• Prosthesis Loosening or Loss of Movement: Over time, the prosthesis may loosen or slip.
• Nerve or Vascular Damage: In rare cases, nerve or vessel damage may occur during surgery.
• Immobility in the Shoulder Joint: Even if a prosthesis is implanted, the joint may not function fully and movement limitation may persist.

Success Rate of Shoulder Replacement Surgery

Shoulder replacement surgery is a highly successful treatment option for most patients. Studies show that the majority of patients experience reduced pain and improved shoulder mobility after surgery. The success rate may vary depending on the patient's age, health status and postoperative care.