Shoulder Replacement Relieves Arthritis Pain: Matthew's Story

Arthritis is a condition characterized by stiffness and inflammation, or swelling, of the joints. 60% of adults in the United States with arthritis are of working age (18 to 64 years). It can limit the type of work they are able to do or keep them from working at all. This was the case for Matthew Clark who served overseas in the Armed Forces, where he developed severe arthritis in his left shoulder.

“The injuries Matthew had sustained accelerated over time, and he was getting progressively worse over the years,” said Jared Mahylis, MD, orthopedic surgeon and an independent physician who chooses to practice at Franciscan Health Olympia Fields.

What Is Arthritis?

Arthritis not one type of disease, but it’s a general way of referring to joint pain or joint diseases. While you may only experience mild discomfort at the beginning of the condition, symptoms can worsen over time.

While there are many different types of arthritis, the two major categories are osteoarthritis (OA) and rheumatoid arthritis (RA). Each of these arthritis types have different causes.

“Arthritis in the shoulder is more common in people over age 60, but arthritis can affect anyone at any age,” Dr. Mahylis said.

How Do You Treat Arthritis?

Treatments for arthritis may vary. Your doctor may prescribe medication, recommend surgery and encourage you to do physical therapy.

For Matthew, he was unable to get relief from prior surgical procedures in 2007 and 2010. He was living with quite a bit of pain despite pain medications and cortisone shots.

Dr. Mahylis said the biggest challenge was to find an appropriate solution for a person Matthew’s age with advanced arthritis.

“Ultimately, we sought to offer him the fastest recovery with the greatest chance of longevity and provide maximum function with range of motion and strength,” Dr. Mahylis said.

When Is Surgery Needed For Shoulder Arthritis?

Your doctor may consider shoulder surgery if your pain causes disability and is not relieved with nonsurgical options. According to the American Academy of Orthopaedic Surgeons, advanced arthritis of the glenohumeral joint can be treated with shoulder replacement surgery, in which the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis.

Replacement surgery options include:

• Hemiarthroplasty. The head of the humerus, the long bone in the arm that runs from the shoulder to the elbow, is replaced by an artificial component.
• Total shoulder arthroplasty. Both the head of the humerus and the glenoid, or the end of the scapula, are replaced in the shoulder. A plastic "cup" is fitted into the glenoid, and a metal "ball" is attached to the top of the humerus.
• Reverse total shoulder arthroplasty. In a reverse total shoulder replacement, the socket and metal ball are opposite a conventional total shoulder arthroplasty. The metal ball is fixed to the glenoid and the plastic cup is fixed to the upper end of the humerus. A reverse total shoulder replacement works better for people with cuff tear arthropathy because it relies on different muscles — not the rotator cuff — to move the arm.

Dr. Mahylis and Matthew agreed the best solution was a full replacement of both the ball and the socket using a new technology that features an augmented socket that is thicker in the back than in the front. This design would compensate for the bone Matthew’s arthritis had worn away in the back of the shoulder joint.

A second unique feature involved employing a stemless humeral component, or stemless ball, another recent development. Traditional replacements use a long stem that goes down inside the bone. 

“Research indicates that 85 to 90 percent of shoulder replacement patients have good functional results with their prosthesis up to 15 years after surgery,” Dr. Mahylis said. “Because Matthew will need a revision at some future date because of his age, we preserved as much of his normal bone as possible.”

Matthew’s successful shoulder replacement gives him the ability to be more active with his young daughter, play with his niece and nephews and exercise pain-free.

“For the first time in years I have zero pain in my shoulder. I have nothing but good things to say about Dr. Mahylis and Franciscan Health,” Matthew said. “He’s very knowledgeable and really gets the job done.”