Shoulder Replacement (Surface)

Surface Shoulder Replacement (Copeland Resurfacing)

Description:

This is performed for arthritis of the glenohumeral joint. We usually use a Mackenzie approach, which also includes an acromioplasty and AC Joint excision (as these are often also affected in patients with arthritis).

A sling is applied with a bodybelt in theatre. The bodybelt is usually removed on the second post-operative day and mobilisation started. The sling must be worn for 6 weeks. Patients may move as much as comfortable, but avoid forced external rotation and resisted internal rotation (to protect the Subscapularis repair performed as part of the surgical approach). They may return to light activities and driving 6 weeks post-op and contact sports 3 months post-op.

Follow-up is at three weeks, six weeks, six months and one year; thereafter annually.

 

Complications:

Complications <1%:

  • Stiffness
  • Infection
  • Bleeding
  • Myositis ossificans
  • Complications related to the Interscalene Block

Complications >1%:

    1. Aseptic loosening may occur and with the older Mark 2 implants this was 5%. The current Mark 3 implants appear to have a loosening rate of <5%.
    2. Revision surgery - Younger patients will probably require revision after 10 years, but a surface replacement is much easier to revise and there are less complications related to revising a surface replacement.
    3. Complications are higher if the Glenoid is replaced 

Alternative Treatments:

Physiotherapy and injections – however most patients will have failed non-operative management before coming to surgery.

Links:

1 – Results of Copeland Surface Replacement

2 - Patient Information

3 - Rehabilitation

4 - More Information

 

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