Total Shoulder Surgery
Is total shoulder surgery right for you?
Total shoulder replacement surgery is recommended when:
- Normal range of motion of the rotator cuff, ball and socket is impeded and has become painful or difficult.
- There has been significant degeneration or injury that has damaged the bone and cartilage.
- Alternative remedies such as physical therapy and medications have not improved mobility.
- Shoulder pain interferes with everyday life.
If you are experiencing any of the above issues, it may be time to schedule an evaluation.
When should you NOT consider shoulder surgery?
Total shoulder replacement surgery is not recommended when:
- The patient has a long history of infection.
- The remaining bone structure is not strong enough to support the replacement piece.
- The patient has unstable muscle mass in the shoulder area and deemed unable to support the replacement.
What is a total shoulder arthroplasty?
Total shoulder arthroplasty is a surgical procedure to replace the ball and socket of the shoulder joint.
A conventional shoulder replacement recreates the normal anatomy of the shoulder by attaching a polyethylene “cup” to the shoulder socket and a metal “ball” to the top of the upper arm bone or humerus.
A reverse total shoulder replacement, alternatively, reverses the placement of the socket and metal ball. The metal ball is attached instead to the socket and the polyethylene cup is placed on the upper end of the humerus.
What does recovery look like?
After the procedure, the patient can expect 2 to 5 days in the hospital with pain and swelling in the shoulder. The patient will be given an arm brace to prevent the arm from moving and be given both pain medicine and antibiotics to lower the risk of infection. Within a couple of days, physical therapy will be introduced. Following going home, the patient will continue with physical therapy until fully recovered. This is expected within 6-8 weeks.
What are the risks involved?
As with any surgical procedure, infection is a risk. The patient will typically receive antibiotics that lower the risk of infection. Although its uncommon, an infection can delay the speed of recovery.
Dislocation is rare, but can occur post-surgery. Since the replacement shoulder is a ball in socket model, it’s possible for the shoulder to become dislocated if the patient is extremely active or exhibits too much motion before full recovery.
Transplant becoming loose
Over time there is a risk of the replacement becoming loose in the bone, this risk can increase if the patient is extremely active and putting a lot of stress on the replacement. This is rare and most often doesn’t require a second surgery.
Leading the field in Total Shoulder Arthroplasty in WNY and worldwide
Dr. Paul Paterson has performed over 2,000 total shoulders. He was the first to perform a reverse total shoulder arthroplasty in Western New York and remains the most experienced. He is a sought after invited speaker and performed a “live” surgery for 500 people as part of an instructional course lecture.
As a leader in the field, Dr. Paterson strives to develop and utilize more advanced techniques. He pioneered a new procedure to reconstruct a portion of the shoulder using the patient’s own bone thus providing a more reliable and durable outcome. He has several patents pending on this procedure. Currently, Dr. Paterson is developing a total shoulder arthroplasty procedure to be performed without disconnecting critical rotator cuff muscles and will be submitting patents in early 2019.
Both the conventional and the reverse total shoulder arthroplasty are performed on an inpatient basis at Erie County Medical Center (ECMC). Patients are released the next day and follow up with outpatient physical therapy at the time of the first post-operative appointment.