If shoulder osteoarthritis causes significant and persistent pain, and medication and physical therapy do not provide relief, orthopedic surgeons at NYU Langone’s Joint Preservation and Arthritis Center may recommend surgery to reduce shoulder pain and stiffness and improve range of motion, helping you remain active.
If your doctor diagnoses osteoarthritis of the shoulder before there is significant cartilage erosion in the joint, he or she may recommend a procedure called arthroscopic debridement. This minimally invasive surgical procedure allows doctors to access the arthritic shoulder joint and remove any bone spurs or pieces of cartilage or other tissue that may be getting in the way of the joint’s function. Removal of bone spurs and other tissue may provide noticeable pain relief and slow down the erosion of cartilage.
To perform this procedure, a surgeon makes a very small incision in the shoulder to access the joint and then insert a long, slim instrument called an arthroscope. The arthroscope has a small camera with a light at the end and captures live images of the interior of the joint that are broadcast on a monitor.
Surgeons use this monitor to guide the insertion of small surgical instruments through additional small incisions in the shoulder. A surgeon uses these instruments to remove the bone spurs and loose tissue.
Surgeons perform arthroscopic debridement using regional anesthesia or general anesthesia. Most people can expect to return home on the same day. Because arthroscopy is minimally invasive, very little damage is done to surrounding muscle and tissue, and most people recover quickly.
Shoulder joint replacement is a procedure to replace the bone and cartilage component of the ball-and-socket glenohumeral joint, which is located where the arm bone meets the shoulder blade, with artificial parts made of long-lasting plastic and metal. Joint replacement surgery is the only treatment option available that can cure osteoarthritis: arthritis cannot develop in the new joint’s plastic and metal materials. A total joint replacement also eliminates the root cause of pain and limited mobility by providing a new, fully functioning joint.
A prosthetic shoulder joint consists of a metal ball attached to a metal stem, which mimics the rounded top of the arm bone, and a plastic socket that is fitted into the shoulder blade. These parts are shaped to fit perfectly in your shoulder joint space and, when combined, result in a smooth and painless gliding motion.
A surgeon performs this procedure using regional or general anesthesia. He or she makes an incision on the front of the shoulder to access the joint. The surgeon cleans out damaged cartilage from the shoulder blade socket and removes the damaged ball-shaped part of the arm bone. The original damaged parts of the joint are replaced with new plastic and metal parts.
After surgery, you should expect to spend about two nights in the hospital, where our nurses and pain management specialists are available around the clock to ensure that you have the pain relief medication you need to recover comfortably.
The next day, a physical therapist visits you to help you gently start to use your new shoulder. Our doctors encourage you to start physical therapy as soon as possible after surgery to build strength around the shoulder joint and expand range of motion. Physical therapists at NYU Langone’s Rusk Rehabilitation are specially trained to assist people with shoulder replacements. They can show you simple exercises to perform while you are still in the hospital, as well as later at home.
When you return home, your arm is in a loose sling for four to six weeks to give your shoulder a chance to heal without bearing weight. The sling can be removed when you eat and sleep. Your surgeon schedules a follow-up visit for 8 to 10 days after surgery to make sure the joint is healing normally.
Physical therapy continues for 12 weeks, either at Rusk Rehabilitation or at a location near your home. During the first six weeks, physical therapists help you restore your full range of motion using stretching and other exercises that improve flexibility. Then, over the next four to eight weeks, the therapists help you strengthen and tone the muscles in your shoulder, arm, and upper back. Improving the strength and flexibility of these muscles provides your shoulder joint with long-term support and stability.
Many prosthetic joints last for years without wearing out or causing complications. But sometimes a prosthetic joint wears out and becomes unstable. If you’ve had a joint replacement, your surgeon may schedule yearly appointments to monitor the implanted joint and, if necessary, explore options to repair or replace aging parts.
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