From an interview with
Dr. Jeremy McCallum
McLeod Orthopaedics Seacoast

Nearly everyone has a sore shoulder at one point in time. And most of the time, medication can help. McLeod Orthopedic Specialist Dr. Jeremy McCallum describes options, when something more is needed.

Here’s a summary of Dr. McCallum’s comments:
The shoulder is a very involved joint and lots of conditions can lead to shoulder pain. Not all of these conditions need surgery. However, some of the more common conditions in the shoulder that end up undergoing surgery include rotator cuff tears, instability and arthritis. As we get older, arthritis is more common. It’s similar to knee and hip arthritis, which can be treated with injections, arthroscopic surgery and shoulder joint replacement surgery
 
A shoulder replacement is similar to a knee and hip replacement. Essentially, an incision is made in the front of the shoulder. We remove the bad cartilage and bone, replacing them with metal and plastic. The surgery relieves the arthritis pain.
 
There are three different types of shoulder replacement —  a hemiarthroplasty (half), a total shoulder arthroplasty and a reverse total shoulder arthroplasty. A hemiarthroplasty is used in younger patients and replaces simply just the ball and leaves the socket alone. This allows for fewer restrictions after surgery and a longer lasting joint. The tradeoff? It may lead to incomplete relief of pain, because only half the joint is replaced.
 
A total shoulder or anatomic shoulder arthroplasty replaces the shoulder, both the ball and the socket. The ball is replaced with metal and the socket with plastic. This allows for better relief of pain, but may include some limitations afterwards, such as limiting lifting and certain activities that could potentially loosen the plastic implant.
 
Finally, there is a reverse total shoulder arthroplasty. Essentially, that takes the ball and places it on the socket side and the socket on the ball side. We use this type of shoulder arthroplasty for really significant boney deformities, as well as large tears in the rotator cuff. Although this type of replacement has less motion than an anatomic or total shoulder replacement, it has an easier recovery and allows shoulder arthritis to be addressed in a patient, who does not have a well-functioning rotator cuff.
 
Shoulder joint replacements are not for everybody. For someone who’s younger and more active, a rotator cuff tear is likely better managed by therapy, injections and, possibly, minimally invasive surgery. If the pain persists as we get older and less active, shoulder arthroplasty may be an option. I don’t necessarily recommend shoulder replacements for everybody, but for the right patient and the right situation, these can be life-changing operations.

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