Shoulder replacement surgery can help many people suffering from the terrible effects of arthritis, but it isn’t always the best option for everybody. Treating younger patients with shoulder arthritis is a controversial issue. They still want to remain engaged in activities, but they also want pain relief with the procedure. To give patients the best possible options available, physicians and researchers have studied the results of total shoulder replacement, compared to partial shoulder replacement in patients less than 50 years old with shoulder arthritis.

Studies have shown that people who get total shoulder replacement do better in terms of pain relief and function, however, the concern with that is the socket piece wearing down over a period of time. Because of this, many people have looked at the option of using a partial shoulder replacement. It was discovered that there was a modest superiority of total shoulder replacement compared to partial replacement in patients 50 years and younger. The concerning thing that doctors found was that there was a higher rate of revision surgery, meaning these people required a re-operation more frequently than what is normally expected.

Total shoulder replacement shown above with implant.

What makes shoulder arthritis so disabling is that people particularly notice the pain at night, so it really interferes with the ability to get a good night’s sleep. A majority of patients tell doctors that they have suffered through pain for a long period of time, and many of them have already tried simple non-operative things such as medication, injections, and physical therapy, yet they have continued to experience pain. This is when doctors usually discuss with patients about the option of a total shoulder replacement, which is essentially placing a ball and socket in the shoulder, versus doing a partial replacement, which doctors insert a smooth metal ball on its own.

With a total shoulder replacement, patients usually experience a 90 percent chance of having good to excellent pain relief. However, the trade-off is that doctors recommend that patients do not lift more than 25 pounds with that arm for the rest of their lives. With a partial replacement, the chances of pain relief are approximately 75 to 80 percent, but those patients can usually go back and do any activity they want. So, one type of operation gives patients a better chance of pain relief, but with more restrictions. The other has a lower percent chance of pain relief, but essentially with no restrictions. This is the dilemma that many patients face when choosing between the two procedures, and really this the focus of the research doctors performed so they could speak to young patients and provide them with some true hard numbers and evidence.

Shoulder replacements began in the mid-1970s and have really grown in numbers since. This is when really the first anatomic shoulder replacement was performed. Over time, there have been additional modifications and improvements. Shoulder replacement is performed less commonly compared to hip or knee replacements. Many arthritis sufferers have never heard of shoulder replacement surgery, and only learn of these procedures when they visit their doctors.

For shoulder replacement surgery, people typically people spend two nights in the hospital after the operation. This is potentially somewhat shorter than hip or knee surgery, but the recovery actually can be somewhat longer. Compared to a hip or knee replacement, many of these patients get back to work within a few weeks, whereas with shoulder placement surgery, people have their arm typically in a sling for six to eight weeks. The recovery can be somewhat longer compared to a hip or knee replacement surgery.

One of the critical components to any shoulder procedure is the postoperative therapy and the ability of the patient to comply with the rehabilitation and restrictions involved. After shoulder surgery, it really does take a dedicated effort on the part of the patient to work on the therapy program to maximize their outcome from the operation. Overall, shoulder replacement surgery in younger patients can provide pain relief and improved motion. However, compared to older patients, studies have shown a higher rate of revision surgery, particularly among those patients that only underwent a partial replacement. If you are suffering from severe pain that is curtailing your activities, consult with your physician so they can discuss the options that are best for you.