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Total shoulder arthroplasty (TSA) can be a successful treatment option for patients who suffer with end stage arthritis or degenerative disease of the shoulder joint. Many patients aren't familiar with shoulder replacement as an option and tolerate pain and restricted motion for a long period of time before seeking medical intervention.
The shoulder is a ball and socket joint held in place by muscles, tendons and ligaments. In TSA the upper arm bone (humerus) is replaced with a prosthetic implant that has a rounded metal head. The socket part of the shoulder joint (glenoid cavity) is replaced with a smooth plastic shell, held in place with special cement. The size of the shoulder replacement is customized to the patient and their lifestyle. The surgery itself takes between 1 - 3 hours and with normal use, most replacement shoulders last for at least 10 years.
Once the postoperative therapy program is complete most TSA patients are pain-free, and able to return to their normal activities without any significant strength limitations.
As when considering any surgical procedure, patients should talk with their doctor to determine if total shoulder replacement is appropriate for their condition. Ideal candidates for shoulder arthroplasty tend to be older with no prior history of large, inoperable rotator cuff tears. Athletes who play contact sports or heavy laborers are not typically good candidates for the surgery because of the long-term demands they place on the shoulder. Patients experiencing early osteoarthritis may consider more conservative management such as physical therapy, over-the counter medication, cortisone or steroid injections, or even a minimally invasive arthroscopic procedure before opting for total shoulder replacement.
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