Total shoulder arthroplasty is also known as shoulder joint replacement. It is a well-established procedure with well-established benefits. It is on the rise due to the growing number of individuals with the degenerative joint disease; and due to the success of TSA in relieving pain and discomfort and restoring shoulder function. More than 70% of patients who undergo TSA have shoulder arthritis. However, TSA may also be recommended when the shoulder joint is fractured, or trauma has destroyed the joint.
What is total shoulder arthroplasty?
TSA is a surgical procedure to treat primarily end-stage degenerative joint conditions. The procedure will remove diseased and damaged parts of the shoulder joint ball and socket and replace them with artificial implants to reliably restore mobility and range of motion, ease pain and restore independence.
The success of the procedure depends on the health of the rotator cuff, and the skill and expertise of the orthopedic surgeon. An intact and functional rotator cuff is a prerequisite for TSA. For patients whose rotator cuff has been damaged in addition to debilitating shoulder arthritis, Dr. Cooper may recommend a reverse total shoulder replacement.
TSA will be recommended when arthritis restricts function and causes every day activities to be painful and challenging; and when nonsurgical treatments fail to relieve pain and disability. TSA is safe and effective. Most shoulder experts agree that the implants have a life span of 15-20 years.
Who is a good candidate?
Good candidates are people over age 50:
- with shoulder osteoarthritis, rheumatoid arthritis or a traumatic injury including some fractures
- with severe shoulder pain that interferes with the ability to perform daily life activities, and
- suffer with moderate to severe pain at night that interferes with sleep, and
- have a loss of shoulder function, and
- have an intact and functioning rotator cuff
The risks and complications of TSA surgery
Risks and complications depend in part of the general health of the patient, and are risks of most major surgeries including bleeding, infection, and blood clots. Other risks include nerve damage, rotator cuff injury, and joint fractures.
Your orthopedic evaluation
During your evaluation with shoulder expert, Dr. Joe Cooper, he will review your medical history, ask about your symptoms and assess your shoulder function, strength and stability. He will order X-rays and imaging studies to evaluate shoulder damage, confirm an intact rotator cuff, and the condition of your bones and soft tissues. He may also order blood tests. With all this information, Dr. Cooper will determine the best options to relieve your pain and improve your function.
When Dr. Copper recommends this procedure, he may also recommend that patients receive a complete physical examination to ensure they are healthy. Patients will receive specific instructions on how to prepare for surgery, and care after surgery.
TSA is often performed under regional anesthesia with an LMA. The arthritic surfaces of the ball and socket are removed and resurfaced with metal and plastic parts. The new parts fixed to the existing bones. The surgery takes about two hours.
You will awaken in recovery and will receive pain medications and a sling to immobilize the joint while it heals. You will receive complete going home instructions including limits on your activities. Many patients are able to go home on same day as their surgery. Prior to surgery you will have scheduled follow up appointments and a rehabilitation plan. Rehabilitation with pain management is vital to allow you to participate in therapy, heal completely and restore function. Full recovery may take 6-12 months.
Dr. Joe Cooper is a shoulder expert who with his surgical team will provide you with top quality care and compassion. He will always provide you with the information you need to make informed choices about your healthcare. Contact him to schedule a consultation.