Advance with MUSC Health

Four Reasons to Consider Shoulder Replacement Surgery Now

Advance With MUSC Health
October 04, 2023
Bearded man wincing and holding his right shoulder

If you haven’t heard of shoulder replacement surgery, you will soon, says Brandon Rogalski, M.D., an orthopaedic surgeon at MUSC Health.

“It’s increasing in prevalence each year, growing twice as fast as hip and knee replacement — yet many people know very little about it,” he says.

Studies show shoulder replacement surgery patients have a low rate of complications and shorter hospital stays than those who have hip and knee replacements, says Dr. Rogalski. A Johns Hopkins study reported 99 percent of patients who had shoulder replacement surgery wished they’d had it sooner.

Four reasons to explore the possibility of replacement surgery

Dr. Rogalski shares four pressing reasons why you should explore the possibility of shoulder replacement surgery, also known as shoulder arthroplasty, if you are managing chronic shoulder pain.

1. Shoulder replacement surgery is a fast-growing, safe procedure with low complication rates.

“It’s not a rare surgery anymore. It’s a safe procedure that uses recent technological advancement to improve your shoulder pain and function,” says Dr. Rogalski.

One of the reasons you may not have heard of shoulder replacement surgery, says Dr. Rogalski, is because arthritis is less common in the shoulder than the hip and knee. Patients with chronic shoulder pain often don’t know replacement surgery is an option.

Not knowing often leads patients to put off action. “When patients talk to friends and family about joint replacement surgery, hip and knee replacement are often the topics of conversation. If shoulder replacement surgery is unknown to that patient’s friends and family members, it may make the patient reluctant to look further into it,” he explains.

Yet the successful outcomes of shoulder replacement are equivalent to or better than other more commonly known joint replacement surgeries.

2. You have prolonged pain, discomfort and immobility.

Signs and symptoms that signal you may need replacement surgery include:

  • Not being able to raise your arm over your head or reach out in front of you
  • Progressive loss of range of motion in the shoulder – you can’t move your shoulder like you used to or have pain moving it in different directions
  • Not being able to do the activities you enjoy, including tasks of daily living
  • Progressive pain in your shoulder, including pain while resting or after taking anti-inflammatory medicine
  • A grinding sensation, clicking or popping sounds with shoulder motion

If activity modification, physical therapy, oral medication and other treatments don’t bring sustained relief, talk to your doctor about replacement surgery.

“Sometimes shoulder replacement surgery is the only option to give a patient back their freedom of motion and ability to perform activities,” says Dr. Rogalski, who specializes in operative and non-operative treatment of shoulder and elbow injuries of athletes, children, adolescents, and adults of all ages.

3. Your arthritis could progress and worsen, making surgery more difficult.

If left untreated too long, “the shoulder can actually start to become deformed,” says Dr. Rogalski, “creating a more challenging surgery.” This can also mean a tougher recovery period.

4. Limiting the amount or way you use your shoulder could lead to muscle atrophy.

Muscle atrophy from prolonged disuse can cause a longer, more difficult recovery after surgery.

Types of shoulder replacement surgery: Anatomic and reverse

An expert in minimally invasive arthroscopic and open surgery of the shoulder and elbow, Dr. Rogalski has expertise in advanced shoulder and elbow reconstructive surgery, including shoulder replacement surgery, rotator cuff tear surgery, shoulder instability and labral tear surgery, elbow arthroscopy and elbow ligament reconstruction and repair.

He explains there are two types of total shoulder replacement surgery, or arthroplasty (TSA). During anatomic TSA, the surgeon replaces the ball and the socket with artificial implants.

During reverse TSA, the surgeon uses implants to replace the ball and socket but flips their location in the joint.

“The reverse replacement surgery allows the patient to power the shoulder using only the deltoid muscle, effectively bypassing the rotator cuff. This makes it a great surgery for patients with irreparable rotator cuff tears as well as arthritis,” says Dr. Rogalski. Reverse TSA is also the preferred surgery for patients with fractures or deformities.

Dr. Rogalski and the TSA surgical team at MUSC Health are experts at identifying and designing a treatment plan for chronic and severe shoulder pain. They carefully consider important factors, including a patient’s level of pain and loss of function, to help determine the need for and type of replacement surgery.

Shoulder Replacement Surgery Recovery

Recovery for patients who have had shoulder replacement therapy is typically three to four months. “Recovery differs slightly between the two types of surgery,” says Dr. Rogalski. “Most people get back to activities in about four months.”

Physical therapy and occupational therapy are a standard part of post-surgery therapy, starting two weeks after the procedure and continuing for about three to four months. Most patients can return to previous activities, including golf, tennis, yoga, weightlifting and other high-impact movement.