Anatomic Shoulder Replacement

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Anatomic total shoulder replacement (also known as anatomic or total shoulder arthroplasty) is a surgical procedure that involves replacing the arthritic or worn out shoulder joint. The main reason to have a shoulder replacement is to relieve pain.  An anatomic shoulder replacement is designed for patients who have shoulder arthritis with an intact rotator cuff.  Arthritis is damage to the shiny white articular cartilage (joint) surfaces of the bone. The rotator cuff is a group of tendons/muscles that hold the ball (humeral head) in the socket (glenoid) of the shoulder and help to raise the arm. 

Fig 1. Anatomic total shoulder replacement prostheses.

            Shoulder replacement is done through an incision on the front part of your shoulder.  Dr. Burns uses the delto-pectoral approach. This approach is between the deltoid and the pectoral muscles on the front of your shoulder. You will be positioned in a reclined position on your back, as if you were sitting in a beach chair. That’s why this is called the beach chair position.  During the surgery, the arthritis is removed and replaced with specially designed artificial parts made of metal and plastic (the prostheses).  The humeral (upper arm) prosthesis consists of a metal ball and stem that is secured into the upper arm bone. The glenoid (socket) prosthesis is made of polyethylene, a special plastic. Occasionally, Dr. Burns may not implant a plastic socket into the shoulder joint; this is called a hemiarthroplasty.The surgery generally takes 1 to 2 hours. Some of this time is used to put you to sleep and properly position you in the beach chair position.

Fig 2. Beach chair position.