Sunday, February 10, 2013

When is it time for a shoulder replacement?

When is it the right time for a shoulder replacement for arthritis?

The question of 'When is the time right for a shoulder replacement?' comes up often. The answer depends on many things, including the degree to which the quality of life of the individual is impaired by the shoulder condition, the condition of the muscles, tendons, bone and nerves around the shoulder, the expectations of the patient, the overall health of the individual, the individual's willingness to accept the risks of surgery, and the degree of comfort the individual has with the surgeon.

As the reader knows from earlier posts, we use the Simple Shoulder Test (SST) to enable the individual to characterize the comfort and function of the shoulder. I recently summarized the SST scores of over 2800 of our patients at the point where they had decided to have a shoulder joint replacement for their arthritis. The average preoperative SST score was 3.9. The numbers of patients with each of the 12 possible SST scores is shown below. Basically, this graph shows that 62% of patients having joint replacement had preoperative SST scores of 4 or below; 30% had SST scores from 5-8; and 8% had scores from 9-12.

Importantly, shoulder joint replacement for arthritis is an elective procedure. Each individual considering joint replacement should seek a surgeon with substantial experience with that procedure and work with that surgeon in discussing the surgical options, the timing of the procedure, and how the risks of the procedure can be minimized.


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