You’ll receive anesthesia before surgery. Two types of anesthesia can be used:
- General anesthesia, which means you’ll be unconscious and unable to feel pain.
- Regional anesthesia to numb your arm and shoulder area so you don’t feel any pain in this area. You’ll also be given medicine to help you relax during the operation.
The shoulder is a ball-and-socket joint. The round end of the arm bone fits into the curved surface at the end of the shoulder blade, called the socket. This type of joint allows you to move your arm in most directions.
For a total shoulder replacement, the replacement parts look like the parts of the body they are replacing:
- The round end of your arm bone is replaced with a rounded metal head (ball). The ball sometimes is supported by a stem that goes into the arm bone. It can be held in place with special cement to allow your bone to grow onto it.
- The socket part of your shoulder bone (glenoid) is replaced with a smooth plastic lining (socket) held in place with special cement.
In a reverse total shoulder replacement, the positions of the ball and socket are reversed. The surgeon will:
- Remove the round end of your arm bone and replace it with a socket tray and a stem that goes inside your arm bone.
- Replace the socket part of your shoulder bone (glenoid) with a round metal head (ball) with screws that go into your shoulder blade.
- Place a plastic liner onto the tray that fits in with the round metal head.
This surgery is usually performed when the rotator cuff tendons are severely damaged or there are certain fractures of the shoulder.
For a reverse total shoulder replacement, your surgeon makes a cut over your shoulder joint to open up the area. Then your surgeon:
- Removes the head (top) of your upper arm bone (humerus).
- Places the new metal ball into the shoulder socket. It is usually screwed into the shoulder blade.
- Inserts a tray onto the upper arm bone. The tray usually has a stem that goes into the arm bone that is secured with special cement to allow your bone to grow onto it.
- Locks a plastic liner in place above the tray to fit with the metal ball.
- Closes your incision with staples or sutures.
- Places a dressing (bandage) over your wound.
Your surgeon may place a tube in this area to drain fluid that may build up in the joint. The drain will be removed when you no longer need it.
This surgery normally takes 2 hours.