and Joint Replacement Dr. James W. Cahill • Dr. David A. Porter • Dr. Paul E. Kovatis • Dr. Michael C. Distefano
Shoulder Replacement Surgery
About Shoulder Replacement
Shoulder replacement surgery may be an option for patients with advanced arthritis if more conservative treatments do not relieve symptoms. Advances in shoulder replacements over the years have led to the development of less invasive, bone-preserving techniques.
Dr. David Porter is fellowship trained in sports medicine and gained experience in shoulder replacement during his orthopedic surgery residency at Lenox Hill Hospital and his fellowship at UHZ Sports Medicine in Miami, FL. Dr. Porter has also worked with sports teams at both the professional and collegiate levels. In addition to traditional shoulder replacement approaches, Dr. Porter is also trained in a new shoulder resurfacing procedure using an inlay glenoid, and is one of the few doctors in the Hackensack, NJ area doing this procedure. This bone-preserving procedure is a great option for younger, more active patients as it allows for early return to activities and less postoperative restrictions.
Candidates for Shoulder Replacement
Arthroscopy can be used to both diagnose and treat certain injuries within the shoulder. Arthroscopy allows Dr. Cahill to perform some shoulder procedures through smaller incisions than would be necessary with a traditional open procedure. A small camera called an arthroscope is inserted into a small incision in the shoulder, which allows Dr. Cahill to view the structures of the joint without having to make a large incision. Other small incisions are made to insert the operating instruments.
Arthroscopy can be employed in the removal of bone spurs, inflamed tissue, and loose cartilage. It may also be used to repair a torn labrum or rotator cuff. Arthroscopic surgery often results in a quicker recovery time and less pain when compared with open surgery. In many cases, patients are able to return home the day of surgery.
Rotator Cuff Repair
Dr. Porter may recommend shoulder replacement if a patient is experiencing the following symptoms and has not had improvement with conservative treatments:
- Advanced arthritis in the shoulder causing shoulder pain that interferes with daily life
- Shoulder pain that continues while at rest, which may prevent the patient from sleeping at night
- Weakness and/or reduced range of motion in the shoulder
Sometimes, shoulder arthritis can occur along with other injuries, including rotator cuff tears and fractures. These patients may need a different surgical approach than patients who only have arthritis. Dr. Porter evaluates all patients on an individual basis and will make recommendations based on the patient’s needs.
Shoulder Replacement & Resurfacing Procedures
Dr. Porter is trained in different shoulder replacement procedures to meet the needs of his patients, including shoulder resurfacing, traditional total shoulder replacement, and reverse total shoulder replacement.
Whenever possible, Dr. Porter recommends a less invasive procedure called shoulder resurfacing with an inlay glenoid. Many patients are eligible for this procedure, and though it is a newer procedure, research shows that patients with this procedure are still doing great at the 10-year mark.
The shoulder is a “ball-and-socket” joint, with the ball-shaped head of the humerus (upper arm) fitting into a socket in the shoulder blade. Traditional total shoulder replacement involves removing the entire “ball” and replacing it with a large metal implant, as well as replacing the socket with an implant. With shoulder resurfacing, Dr. Porter is able to preserve much more of the patient’s normal anatomy. Instead of removing the entire head of the humerus, a metal cap is placed over the damaged area of the shoulder. There are different-sized caps available so that only the damaged portion of the shoulder is resurfaced.
There are several benefits to shoulder resurfacing, including:
- The ability to retain more of the patient’s healthy bone and cartilage.
- The patient can return to sports and activities more quickly than with a shoulder replacement.
- No activity restrictions as compared to a total shoulder replacement, so patients can remain active in high-demand sports like weightlifting.
These benefits make shoulder resurfacing a particularly great option for younger patients who need a shoulder replacement to eliminate arthritis pain, but want to remain active.
Total Shoulder Replacement & Reverse Total Shoulder Replacement
Though the majority of patients are eligible for shoulder resurfacing, a patient may need a total shoulder replacement if there is extensive damage to the shoulder, poor bone quality, or if fractures or rotator cuff injuries are present.
Total shoulder replacement involves removing the entire head of the humerus (upper arm) and replacing it with a stemmed metal ball-shaped implant. The socket is also replaced with an implant and lined with a plastic spacer.
For patients that have a large, complex rotator cuff tear, reverse total shoulder replacement may be recommended. With this procedure, the positioning of the ball and socket are reversed. The head of the humerus is removed, but instead of replacing it with a ball implant, it is replaced with a stemmed socket implant. The damaged bone and cartilage is then removed from the natural shoulder socket, and a metal ball-shaped implant is put in its place. By reversing the positioning of the ball and socket, the shoulder can rely on the deltoid muscles to lift and rotate, rather than the rotator cuff.
Recovering from Shoulder Resurfacing
Shoulder resurfacing is an outpatient procedure, meaning that patients are able to return home the day of surgery. Shoulder resurfacing is less invasive than total shoulder replacement, which tends to result in less blood loss during surgery. Dr. Porter’s team uses multimodal pain management techniques to help with pain in the initial recovery phase.
Patients will receive specific postsurgical instructions from Dr. Porter. It is very important to follow these instructions for the best possible outcome. Patients will participate in physical therapy during the recovery process to improve strength and range of motion in the shoulder. Dr. Porter will advise when it is appropriate to return to work and activities like driving and sports.
Most patients fully recover from shoulder resurfacing in an average of 3 months, though this depends on the individual patient. Patients are typically able to return to all of their usual activities without permanent restrictions, including sports like weightlifting, once they are fully recovered.
Shoulder Replacement & Resurfacing in Hackensack, NJ
Dr. David Porter is a board-eligible and fellowship trained orthopedic surgeon in Hackensack, NJ. During his sports medicine fellowship, he worked with sports teams on the professional and collegiate levels and gained extensive experience in shoulder surgery, including shoulder resurfacing and shoulder replacement. Whenever possible, Dr. Porter uses less invasive, bone-preserving shoulder resurfacing to allow active patients to return to their sports.
If you would like to schedule a consultation with Dr. Porter, please call our office at (201) 489-0022.