Shoulder replacement

Shoulder replacement offers a good solution for people suffering severe pain and loss of function due to wear and tear of the shoulder joint. That wear may consist purely of bony wear or be accompanied by tendon blade injuries.

New developments in shoulder surgery in recent years have resulted in significant advances in treating serious shoulder injuries.

For severe fractures, where the head of the shoulder is irreparably damaged, a shoulder prosthesis is implanted.

• Anatomical shoulder replacement: for osteoarthritis
• Reverse shoulder replacement: for arthrosis and tendon damage
• Stemless or ‘resurfacing’ shoulder replacement: for arthrosis
• Hemiarthroplasty: for complex fractures of the humeral head

Advanced wear and tear of the shoulder involves damage to both the humeral head and glenoid cavity. Resurfacing or replacement of the affected surfaces with a shoulder prosthesis will alleviate or resolve the pain and improve mobility. In anatomical terms, this means that there are no changes to the shape of the shoulder. The shoulder ball and socket retain their form. The opposite is the 'inverted' shoulder prosthesis, in which a pan section is made from the head, with a spherical structure placed on top of the pan. The latter is done in case of absence or insufficiency of the tendon.

For relatively young patients who only have wear and tear of the humeral head but whose glenoid is still intact, we opt to only replace the worn surface of the ball. In this case, we refer to it as a stemless shoulder prosthesis or a resurfacing/relining prosthesis. This situation is quite unusual.

In case of serious shoulder fractures, the humeral head may be damaged to such an extent that we have to replace it with a plastic ball. We call this a 'hemi' or half-prosthesis. Only the head is replaced, and the pan remains in situ. Using strong threads, the bone segments that have been broken off and the tendons attached to it are reattached to the prosthesis. The stem is often fixated into the shaft using bone cement. This involves highly complex fractures. The procedure is therefore also highly complicated and the result is often unpredictable. In many cases, acceptable, albeit not full, recovery of shoulder function can be achieved. Rehabilitation is often difficult and takes a long time.

Latest publication date: 02/08/2024