Total Shoulder Resurfacing

What is total shoulder resurfacing?

Total shoulder resurfacing (TSR) is an alternative to conventional total shoulder arthroplasty (TSA). TSR is suitable for younger patients or physically active older patients who have advanced glenohumeral arthritis that isn’t responding to nonoperative treatments.

Total shoulder resurfacing (TSR) is bone conserving and less invasive than total shoulder arthroplasty, which involves replacing the shoulder joint. TSR allows patients to start moving their shoulder and begin physical therapy sooner, and typically leads to a quicker recovery.

TSR is an outpatient procedure and full recovery after following a physical therapy program takes about 8-12 weeks. After your recovery, you have no restrictions on your activities as you would after TSA.

What is total shoulder arthroplasty (TSA)?

TSA involves using a prosthetic shoulder joint replacement. Dr. Kovack reams down the arthritic socket, cementing in a new plastic socket and fitting a metal humeral implant with a stem and a ball. TSA prosthetics last 15-20 years, and patients who have end-stage osteoarthritis consistently experience significant pain relief and improvement in function following TSA.

However, it’s typically patients over 60 with severe glenohumeral arthritis who undergo TSA. These patients are less demanding of their shoulder joints than younger, more active patients, who need to achieve different outcomes from shoulder surgery.

Why is TSR a better option than TSA for certain patients?

If you’re in the 30-50 age range, or over 60 and active, you’re likely to want to keep playing sports, exercising, and functioning at a high level after shoulder surgery. TSA may not be suitable for you because the surgery requires removing a significant amount of bone.

As a result, if you have TSA at a younger age there could be insufficient bone for further surgeries, meaning another replacement in the future wouldn’t be possible. The cement used to fix the new plastic socket could loosen and affect joint function, and revision surgeries are often not as good as the initial procedure.

TSR offers advantages over TSA for many patients, as it eliminates the problems TSA might cause if you’re physically active. For the humeral head resurfacing (HHR) part of TSR, Dr. Kovack uses a custom-fit metal cap that presses into the bone in your shoulder. The bone grows into the cap, forming a solid union that’s stronger than the cement used in TSA.

For the glenoid resurfacing (GR) part of TSR, which involves the ball part of the ball and socket in your shoulder joint, Dr. Kovack can use either a plastic or poly implant or a fresh osteochondral allograft from a donor.

Plastic inlay implants sit within the bone, and are secure. Using osteochondral allograft from a donor ensures maximal bone preservation. Dr. Kovack can discuss which option is best for you at your consultation.

TSR is a great option for younger, physically active patients, providing an alternative option even if you feel like you have no choices open to you. Dr. Kovack is highly sought after because of his specialist expertise in TSR, so call him today or use the online booking form to schedule a consultation.

To see pictures and videos about Total Shoulder Resurfacing and Dr. Kovack’s specialized techniques, click here.

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