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Arthroscopic stabilisation    Reverse Replacement    Shoulder Replacement - Types
Expectation:
Joint replacement surgery is a major surgery and is intended to give a good pain relief with better quality of life and more normal sleep pattern. Unfortunately, although there is a significant improvement in the movement, it will not restore normal ranges of movement. Moreover, it is not a permanent solution and like any other joint replacement will not last forever and may require revision.
What type?
There are 3 main ‘types’ of shoulder replacements. New and advanced techniques like short stem or stemless replacement are being introduced.
The three types that are available are

Surface replacement - ‘Copeland’ type

Hemi-arthroplasty - Stemmed or ‘Eclipse’ type

Total shoulder replacement  
Surface replacement:
I offer this technique to relatively young patients who have no significant arthritis in the glenoid side, have good bone stock and nearly ‘round’ humeral head without any deformity. The operation involves removing few millimetres of the bone to create a hemispherical shape and a metal cap is placed to cover this as a replacement. As very little bone is removed is to be viewed as bone preserving operation.
In addition to the replacement of the surface with the metal cap, another important element is the replacement is to release all the tissues around the joint. Complication rates are low. In young patients this can be looked as stepping stone to a major operation.
I hesitate to offer this to a patient who has boor bone quality or significant osteoporosis as the bone stock is likely to be poor. In such cases, the implant may not ‘bond’ well to the bone and can become loose. Such surface replacements may last for 10 year or more in 95% of times. It can be converted to other types of joint replacement relatively easily if needed in the future.  
Hemiarthroplasy:
This is the standard joint replacement technique which I offer to most people with arthritis. The replacement involves inserting a metal rod in the middle of the arm bone and coupling it to a metal ball. The soft tissue release is also done. Drilling small holes in glenoid will be done if necessary to allow a growth of fibro-cartilage. Complication rates are low with this type of procedure.
Hemiarthroplasties last for 10 to 12 years in 95% of cases. If necessary, this can be converted to a total shoulder replacement at a later stage; but this is a much more challenging operation than converting a surface replacement.

Total Shoulder Replacement:
When a total shoulder replacement is done, in addition to performing the hemiarthroplasty, the socket is also replaced with a plastic button. This allows the artificial joint surfaces to glide without friction or rubbing on worn out bone. Cumulative complication rates are higher due to the extra step involved. When it goes well, the early results of pain relief and range of movement is better than hemiarthroplasty alone. However, the plastic button used does not last forever and it can result in erosion and weakening of the bone which makes revising this a much more challenging situation due to the loss of bone stock in the both sides of the joint. Total shoulder replacements lasts about 10 to 12 years.
Thus if total shoulder replacement is done in younger age group, it will pose a much more difficult situation when it requires revision; more over, in my experience, the younger age group will wear out the plastic much more quickly than older and therefore in younger age group, the total joint may not last 10 years.

At present, following joint replacement surgery patients are required to remain overnight in the hospital and will need to rest the arm in a sling for about 4 weeks.