Dr. Steinmann describes the surgical options available for shoulder arthritis.
The surgeries that we do for shoulder arthritis are one, we can do a minimally invasive technique where we use the arthroscope to go into the shoulder joint, clean out some of the debris, often we have arthritis – the cartilage breaks down and you get cartilage floating around in the joint. You get small pieces of bone. You can actually develop bone spurs, also the head of the humerus, which is the main bone of the shoulder, and also the socket, and arthroscopically you can clean up some of those bone fragments, take out some of the degenerative cartilage and release some of the capsule, the capsule, the joint also can get tight.
It can release that, remove some of those bone and cartilage products and the patient can get some relief from that. That may delay a more extensive surgery for a year or two, that’s a possibility. Not every patient would be a candidate, necessarily, for that and whenever you do consider a minimally invasive technique such as arthroscopy you have to discuss frankly with the patient that it may not give them the relief that they are looking for and we may need to do a formal open treatment for that patient later on that year.
So, I always tell the patient, I kid with them and say, “Don’t be mad at me if it doesn’t work. We gave it a try and now we need to do, the next step would be a replacement,” and there are two types of replacements we can do for the shoulder – we can do a complete replacement where you replace the socket, with usually it’s a plastic component and we’ll place the ball at the top of the shoulder with a metal component. That’s a formal replacement.
In some patients who are active we can do a resurfacing replacement where almost like a cap on a tooth, we put a cap on the ball part of the shoulder and don’t do anything to the socket itself and in some patients are candidates for that. So a little bit less invasive technique and there’s a little bit less risk of down the road loosening and potential problems with that shoulder.
The things that I caution my patients about after they’ve had a total shoulder, which is again the plastic component, the socket and the metal head, is that after they have that they do need to think a little bit more about the activities that they do. I think playing tennis and golf is fine, but weightlifting, real strong activities, going back to work, a job position that requires a lot of overhead lifting and a lot of strain I think is probably not a good idea after you’ve had a plastic and metal replacement.
I say, you have a car partner and just like your car wears, your shoulder is going to be wearing now. That little bit of plastic debris is only going to get more and more and more use your shoulders, but I tell patients not to become a shoulder cripple, so to speak, after they have a shoulder replacement. They live life to the fullest, but just think carefully about the activities that they do, but golf and tennis I think are fine for doing that.
About Dr. Steinmann, M.D.:
Dr. Scott P. Steinmann, M.D., is on orthopedic surgery at the Mayo Clinic Sports Medicine Center in Minnesota. Dr. Steinmann received his medical training from Cornell University Medical College in New York, completed his residency in orthopedics at New York Orthopedic Hospital and completed a fellowships focusing on the shoulder and hand surgery from Columbia-Presbyterian Medical Center and Mayo Graduate School of Medicine respectively.