Surgeons may perform osteoarthritis shoulder surgery in severe cases of osteoarthritis. The main types include arthroscopy and total shoulder replacement. Surgery can help relieve pain and restore motion.
Shoulder osteoarthritis is when the smooth cartilage covering the bones that form the shoulder joint begins to wear down. This can happen from overuse, injuries, trauma, and the wear and tear of aging.
Shoulder osteoarthritis can be very painful and significantly impair a person’s quality of life. While there is no permanent cure for osteoarthritis, surgery is one treatment option to help manage the pain and improve range of motion where possible.
This article discusses the types of osteoarthritis shoulder surgery and their benefits. It also examines when doctors may recommend the surgery, what to expect, and more.
If nonsurgical or natural treatment options for osteoarthritis have not been effective, there are two main kinds of procedures surgeons may recommend for shoulder osteoarthritis.
Arthroscopy is a minimally invasive operation that involves making a small incision in the skin and inserting a small camera inside the shoulder joint.
The camera displays images on a video monitor, which the surgeon uses to guide small surgical instruments. They can then manipulate the tissue to take out loose pieces of cartilage or bone inside the joint.
This type of procedure may play a part during the early stages of arthritis when damage to the joint’s surface is still minimal.
The arthroscopic procedure does not get rid of arthritis, but it can help remove fragments of tissue that could irritate the joint and cause pain.
A person will receive an anesthetic before the surgery to limit discomfort.
Learn more about arthroscopic surgery.
This type of procedure is sometimes called a total shoulder replacement or arthroplasty. It is similar to knee replacement or hip replacement surgery.
During this procedure, surgeons use implants made from metal and plastic to make new surfaces for the joint.
When severe cartilage degeneration has damaged only the ball surface or only the socket surface, full shoulder replacement is modified. This procedure is called hemiarthroplasty.
During total shoulder replacement, the surgical team makes an incision along the shoulder surface to remove the arthritic ball of a person’s shoulder and replace it with a metal prosthetic ball.
The metal ball connects to a stem that is permanently attached to the upper end of the humerus. The surgeon then restores the damaged socket with a smooth plastic socket.
In select cases, reverse shoulder arthroplasty is performed: The anatomical positions of the artificial ball and socket are reversed, so the ball is attached to the shoulder bone, called the scapula, and the socket is situated at the head of the humerus.
The movement of the metal ball in the plastic socket helps relieve pain by eliminating the friction bone-on-bone grinding causes.
Before the surgery, a person will receive either a local or general anesthetic to limit discomfort.
Arthroscopy can help treat symptoms in milder cases of arthritis. Arthroscopy may be preferred to other, more invasive types of surgery due to factors such as a quicker recovery time.
The benefits of total shoulder replacement surgery for osteoarthritis include:
- relieving pain
- restoring motion
- improving strength and mobility of the shoulder
A doctor can discuss the benefits of their recommended procedure and advise on any possible risks so that the person can make an informed decision about their treatment plan.
Doctors may recommend osteoarthritis shoulder surgery if symptoms do not respond to nonsurgical treatments.
Typically, for a doctor to recommend shoulder replacement surgery, progressive stiffness and a grinding sensation in the bone accompany the pain.
These symptoms indicate that bones forming the ball-and-socket joint of the shoulder are beginning to rub or grate against one another due to the wearing away of the cartilage that should cover them.
The best candidates for total shoulder replacement surgery are those with well-functioning rotator cuff muscles and minimal glenoid wear.
A doctor can provide information about anything special a person needs to do to prepare for osteoarthritis shoulder surgery.
Preparation might include stopping eating or drinking at a certain time, either on the day of the surgery or the night before.
It is also best for a person to inform their doctor about any medications and supplements they take. The doctor can advise on whether the person should stop taking them before the surgery, and if so, at what time.
A person may need to undergo various tests before surgery. These tests may include:
- blood tests
- electrocardiogram (EKG)
- chest X-ray
The time it takes for the procedure can depend on the type of surgery.
Arthroscopy typically takes less than 1 hour. Shoulder replacement surgery can take around 2 hours.
After surgery, a person typically remains in a recovery room for 1–2 hours. During this time, nurses can monitor them and provide any necessary pain relief medication.
The person will need someone to drive them home afterward. At night, they may find it easier to sleep propped up in bed or in a reclining chair.
The surgical team can provide detailed instructions on how to care for the shoulder after the procedure.
As with any surgery, there are possible risks.
Possible complications of shoulder surgery for osteoarthritis include:
- problems with the prosthetics
- adverse anesthetic events
- nerve damage
- blood clot formation
The surgeon can discuss the risk of complications and answer any questions beforehand.
Here are some more frequently asked questions about shoulder surgery for osteoarthritis.
What is the recovery time for osteoarthritis shoulder surgery?
Although recovering from arthroscopic surgery typically takes less time than recovery from open surgery, a person can still expect it to take weeks or months for the shoulder joint to recover completely.
Pain and discomfort may persist for several weeks after surgery.
How successful is shoulder surgery for arthritis?
Success depends on a person completing rehab exercises for their shoulder to strengthen and stretch the muscles.
After successfully completing a rehab exercise program, 95% of people have pain-free function 1 year after surgery. They can play sports and exercise again.
How do you fix osteoarthritis in the shoulder?
There is no cure for osteoarthritis in the shoulder. In the early stages, a person can use nonoperative treatments, such as pain medication and stretching and strengthening exercises to increase mobility in the joint.
However, once the cartilage wears down too much, surgery often becomes necessary to relieve pain and restore quality of life.
What are the 4 stages of osteoarthritis in the shoulder?
The four stages, or grades, of shoulder osteoarthritis are:
- Grade 1: The cartilage begins to soften.
- Grade 2: The cartilage develops fissures or cracks in the surface.
- Grade 3: Cracks affect the subchondral bone, which is the bone beneath the cartilage, with a diameter greater than 1.5 centimeters.
- Grade 4: The cartilage wears away almost completely, exposing the surface of the bone.
This information is based on the
A doctor may recommend osteoarthritis shoulder surgery if symptoms of osteoarthritis do not respond to other treatments or if the condition is severe.
The two most common forms of surgery for shoulder osteoarthritis are arthroscopy and total shoulder replacement. A doctor can advise on which type of surgery they recommend and what a person can expect before, during, and after the procedure.
It is best for a person to contact a doctor if they have concerns about the symptoms of osteoarthritis or if they wish to discuss their current treatment plan.