Total Shoulder Arthroplasty
The modern era of shoulder replacement began in the 1950s, but the techniques and implants we most commonly see today were developed in the 1980s. Thankfully, the technology and techniques are continually improving to what we utilize today and this procedure is one that has shown a great leap in technologic advancement. Total shoulder replacement (also referred to as “arthroplasty”) involves removing the arthritic portions of the shoulder, or glenohumeral, joint. Once they are removed, metal implants and a specialized plastic are placed within the humerus and glenoid that comprise the shoulder joint.
These implants may be secured to and within the bone with with cement, or “press fit”, meaning the implant is essentially wedged into the bone and has an extremely high friction type of metal that locks it into the bone. There is a traditionally a polyethylene component placed between the humeral head and the glenoid, or the glenoid component may be entirely made of polyethylene. There are newer techniques, depending on the pathology of the shoulder and the rotator cuff integrity, that may utilize a “Reverse Total Shoulder Arthroplasty”. where the glenoid component is spherical and convex and the humeral component is concave. After surgery, patients can begin a physical therapy program aimed at rebuilding strength and improving range of motion
Shoulder Osteoarthritis Surgery
There exists a wide variety of treatment options for shoulder osteoarthritis. Conservative measures can be used such as physical therapyanti-inflammatories, along with corticosteroid injections, hyaluronic acid injections, or platelet rich plasma (PRP) injections into the glenohumeral joint . However, because cartilage does not regenerate, neither of these options truly addresses the underlying arthritic changes of the shoulder joint, and are temporary measures for pain relief.
Partial shoulder replacements and total or reverse shoulder replacements are options that involve replacing part of the shoulder joint or replacing it entirely with metal components
Shoulder osteoarthritis can be significant cause of pain and disability in the upper extremity. Cartilage helps allow for motion in the joints of the body, but it can be degraded over time. The glenohumeral or shoulder joint is no exception: the actions of daily life can cause the cartilage to be irreparably damaged leading to pain decreased range of motion.
Additionally, shoulder osteoarthritis may occur in the setting of a rotator cuff tear, which is the group of muscles that allow for shoulder movement. This can further decrease range of motion at the shoulder joint. In this instance, a reverse total shoulder arthroplasty is an excellent surgical option and has become incredibly popular and routinely performed in the United States.
The Stryker ReUnion® TSA system is an option for total shoulder replacements. The ReUnion® system has an all polyethylene glenoid component that removes the possibility of wear between a polyethylene liner and metal component that could require future surgery.
It has multiple options for humeral heads with differing thickness to allow for a more tailored fit to the patient’s individual anatomy. It also has a platform for the humerus component that allows for easy transition to other options in the future should there be a need for more surgery. The glenoid component is also designed to pressure the cement placed to help ensure even more secure fixation.