Anatomic Total Shoulder Replacement

Anatomic total shoulder arthroplasty is the gold standard procedure for patients with shoulder dysfunction including extreme loss of motion and significant pain. The patient must have an intact rotator cuff and sufficient socket bone to accommodate an implant. It has been shown to provide good to excellent results, reliable patient satisfaction, excellent implant longevity and low rates of complications for these patients.

This procedure is complex and involves replacing the damaged parts of the shoulder joint with artificial components. The surgeon removes the arthritic or injured surfaces of the humeral head (the ball) and the glenoid cavity of the scapula (the socket) and replaces them with a metal ball and a plastic socket, respectively. This restoration mimics the natural anatomy of the shoulder, allowing for a more natural range of motion and pain relief.

This surgery is typically indicated for patients suffering from advanced shoulder arthritis (osteoarthritis or rheumatoid arthritis), severe shoulder fractures, or degenerative joint disease. It is also used when other treatments, such as medications, physical therapy, or less invasive surgeries, have failed to relieve symptoms.

Dr. Kaplan may recommend an anatomic total shoulder replacement for patients who have significant shoulder pain that affects their quality of life and daily activities, along with a reduced range of motion. Candidates are generally healthy enough to undergo surgery and committed to following post-operative rehabilitation to ensure successful recovery.

The first step is to schedule a consultation with Dr. Kaplan. He will perform a comprehensive evaluation of the shoulder joint to assess the severity of damage and determine the suitability of the procedure. The process includes the following key components:

Dr. Kaplan will review the patient’s medical history, including symptoms, duration of pain, impact on daily activities, previous injuries, and any treatments tried (e.g., physical therapy, medications). He will perform a physical exam to assess shoulder function. This involves checking range of motion and evaluating the strength of the shoulder muscles and the rotator cuff. He will feel for tenderness, swelling and deformities around the joint, and test joint stability

Dr. Kaplan will order imaging studies to visualize the condition of the joint including X-rays for detailed images of the bones in the shoulder, to reveal the extent of arthritis, bone spurs, or joint deformities. He may also order an MRI or CT scan for more detailed imaging to evaluate bone quality, the condition of the rotator cuff, and the soft tissue structures around the joint.

Since anatomic total shoulder replacement requires an intact and functional rotator cuff for proper joint movement post-surgery, Dr. Kaplan will thoroughly assess these muscles through physical examination and imaging. This evaluation will help him decide if an anatomic total shoulder replacement is appropriate or other treatments may be more suitable.

During the procedure, Dr. Kaplan will make an incision over the front of the shoulder, remove the arthritic or damaged surfaces of the humeral head (ball) and the glenoid cavity (socket). These are then replaced with a metal ball and a plastic socket that mimic the natural anatomy of the joint. The goal is to restore the shoulder’s function and relieve pain, allowing for smoother movement and improved range of motion.

The surgery is performed either under general anesthesia or with a nerve block and sedation.  Patients typically go home the same day as the surgery (same-day surgery).