Your doctor may suggest a total shoulder replacement surgery if you have shoulder pain so severe that it prevents you from doing simple tasks like reaching into cabinets, sleeping soundly, scrubbing your hair during a wash, or any other symptoms. Your mobility may improve as a result of this surgery. A typical total shoulder replacement procedure which takes one to three hours, is described below.
Checking the patient and administering anesthesia
Before beginning surgery, the patient’s blood pressure, heart rate, body temperature, and oxygenation levels are assessed. Then the affected shoulder is marked before the patient enters the theater to avoid confusion.
After that, the anesthetist administers anesthesia to the patient. Some patients need extra-regional anesthesia to numb the area being operated on. A patient’s anesthetic form is agreed upon before the procedure.
The surgery
Here is what happens during a total shoulder replacement surgery:
Starting at the top and front of the shoulder and curving along the deltoid muscle, the surgeon cuts about 6 inches long. To access the shoulder joint, the surgeon cuts through deeper tissue, including a rotator cuff tendon.
The glenoid, or socket, of the scapula, is separated from the top of the upper arm bone, known as the humeral head. The surgeon examines the area immediately below the humerus’s rounded head, known as the humeral neck. They remove any bone spurs that may have grown on the humeral neck due to arthritis using an osteotome, and t
he humeral head is removed using a bone saw.
After the surgeon prepares the humerus bone, they install the prosthetic humeral stem. A little, tapered metal shaft called the humeral stem is fitted several inches down into the humerus. This stem’s top is made to accommodate a prosthetic ball that will take the place of the human humeral head. To prepare the shoulder socket (glenoid) for its prosthesis, the surgeon employs a specialized instrument known as a reamer.
To allow for easy movement with the prosthetic humeral head, the artificial socket, or glenoid prosthesis, is typically composed of polyethylene. The prosthetics can be cemented-in or cementless (also known as “press fit”) components, depending on how they are attached to the native bone, and the quick-setting bone cement only needs 10 minutes to set.
Once firmly fixed in position, a temporary prosthetic ball is affixed to the top of the humeral stem. The surgeon checks to see if the shoulder joint is easy to move and does not dislocate by inserting the provisional ball into the new socket and moving the shoulder.
The final ball prosthetic will then be attached after the surgeon has dislocated the joint and removed the trial or temporary component. The surgeon places the ball in the new socket while inspecting it for dislocation and ease of motion.
Then the skin incision is sewn or stapled back together once the muscle and other soft tissues that were cut. After the surgery, observation is necessary while the surgical anesthesia wears off.
