Roughly 18% to 26% of adults cope with shoulder pain. Some people will need to undergo surgeries like shoulder replacement or rotator cuff surgery to treat chronic shoulder pain.
This article discusses what goes into both procedures and why a person may choose one over the other.
What to Know About Shoulder Replacement
Shoulder replacement surgery can resolve damage from various problems such as osteoarthritis, rotator cuff injuries, and fractures.
How Does It Work?
A shoulder replacement surgery involves removing damaged bone in the shoulder joint and rotator cuff and replacing it with implants. In some cases, the entire joint in the shoulder will be replaced.
The procedure usually is highly successful at reducing pain and improving shoulder mobility.
Treatment Delivery
There is more than one type of shoulder replacement surgery. The type you get will depend on the extent of the damage. The three types are:
Can Anyone Get Shoulder Replacement Surgery?
Some people may be ineligible for shoulder replacement or are at a higher risk for complications. People who should not consider this type of surgery include:
Those under the age of 59
Cigarette smokers
People with osteoporosis (condition that causes weak, brittle bones)
Someone with irreparable damage to their rotator cuff
Damage in nerves that go from the shoulder to the spine
Total replacement: Removes the entire “ball and socket” shoulder joint and rebuilds it with artificial implants made from plastic, metal, or cement
Partial replacement: Only removes damaged areas
Reverse replacement: Removes and replaces the entire shoulder joint by reversing positions of ball and socket to use deltoid muscles to move the shoulder (used in cases with a more damaged rotator cuff)
All three types of shoulder replacements are done in a hospital.
Side Effects
While this procedure is often considered safe and effective, there are some side effects, including:
How Long Will I Be in the Hospital?
Most people spend an average of three to five days in the hospital for this type of surgery. The length varies depending on how well a person responds to the surgery and their personal healing time.
- Mild painSwelling in the area Reduced strength and mobility
Prices and Where to Get It
Shoulder replacement surgery is performed in a hospital by a surgical team, including an orthopedic surgeon. The cost of a shoulder replacement procedure can be $14,000 to $52,000. That cost may be reduced with medical insurance. However, not all insurance plans will cover it.
Shoulder Replacement Surgery Complications
In rare cases, serious complications can occur following this procedure, including:
If you have Medicare insurance, you will pay between $805 and $1,473 for your shoulder replacement surgery.
What to Know About Rotator Cuff Surgery
Rotator cuff surgery is used to help treat shoulder pain caused by shoulder injuries. The rotator cuff is the part of the shoulder that a person uses when they reach their arms up. The tendons and muscles that make up the cuff can become injured or tear, resulting in pain and limited mobility.
Other Costs Associated With Shoulder Replacement
Along with the surgery itself, people undergoing this procedure also have to consider aftercare costs, such as physical therapy and medications.
How Does It work?
The surgery is designed to restore mobility in the arms as well as reduce pain. For many people with injuries to the rotator cuff, surgery is a good option to restore the function and flexibility of the shoulder.
The two ways a surgeon can perform rotator cuff surgery are:
Other Treatments for Rotator Cuff Injury
Typically, other treatments are explored prior to this surgery such as:
Nonsteroidal anti-inflammatories (NSAIDs) such as Advil or Tylenol to reduce pain and inflammation
Physiotherapy to help strengthen and repair the rotator cuff
Steroid injections
Rest
Arthroscopic surgery: This type of surgery involves the use of a small instrument with a light and camera on the end of it. It is inserted into the shoulder joint to guide the surgeon, who then enters from a separate small incision with the tools needed to fix the injury.
Open surgery: Open surgery is the traditional approach. It involves cutting into the skin to expose the rotator cuff so that it’s easier to repair. In some cases, a graft using tendons from elsewhere in the body is used.
If these two options are unsuccessful, a shoulder replacement may be required.
Following the surgery, you may experience many side effects, including:
Why Else Would a Rotator Cuff Surgery Be Necessary?
In some cases, age-related degeneration can damage the rotator cuff. In this instance, surgery is necessary if the symptoms are difficult to cope with.
- A swollen arm and hand
- Swelling in the shoulder
- Skin color changes around the incision
- Fatigue
These side effects shouldn’t last longer than a week. Other side effects, such as immobility in the shoulder, will last longer. It could be a few months before you have full use of both your shoulder and your arm after rotator cuff surgery.
The surgery is performed in a hospital or ambulatory surgical center by an orthopedic surgeon. It is typically considered an outpatient procedure, which means that patients leave the hospital on the same day the surgery is performed.
Rotator Cuff Surgery Risks
Although rare, there are certain risks associated with rotator cuff surgery, including:
The average cost to have rotator cuff surgery sits at roughly $22,894 without insurance. In many cases, this procedure is considered elective since it does not directly treat any disease. Because of this, many insurance providers will not cover the cost.
Medicare will cover the surgery in some cases, but it has to be deemed medically necessary by your healthcare provider before they consider covering it. They are unlikely to pay for it as it affects only quality of life.
Which Treatment Is Right for You?
Your healthcare provider is tasked with determining which surgery is best for your current situation. In many cases, both procedures are done only if completely necessary. If your shoulder joint is not damaged at all, rotator cuff surgery is a better option. However, if there is damage to the joint, shoulder replacement is likely the best procedure to go with.
What Can I Do to Make Sure I’m Covered?
Aside from getting an insurance plan that specifically states that this procedure is covered, you can speak to your healthcare provider about the medical and health implications of your injury. If they can provide the appropriate documentation, you are more likely to be covered for the procedure.
In some cases, shoulder replacement surgery may be done following a rotator cuff surgery if it does not fix the issue.
Can Shoulder Replacement or Rotator Cuff Surgery Be Used Together?
A shoulder replacement surgery may be done at the same time as rotator cuff repair. This is because shoulder replacement surgery requires the tendons and muscles in the rotator cuff to help hold the implants in place. Joint damage and tears in the rotator cuff may also occur simultaneously.
Meeting With a Healthcare Provider
When you meet with your healthcare provider, they will give you the options that would be the most effective in treating your specific type of shoulder pain or injury.
That said, the extent of the rotator cuff injury matters when considering both surgeries at the same time. Research has shown that smaller tears in the rotator cuff equate to a better overall outcome than larger ones.
The type of shoulder replacement also matters. Smaller tears in the rotator cuff can be repaired during total shoulder replacement, however, the repair of medium and large tears is better suited for people undergoing reverse shoulder replacement surgery.
Coping With Side Effects
The side effects of both a rotator cuff surgery and shoulder replacement are similar and include swelling, pain, and limited shoulder function. Shoulder function will be restored over time using specialized exercises and movements. The pain and swelling can be alleviated through the use of over-the-counter or prescribed pain medications and icing the affected area.
Benefits of Combined Surgeries
If you are undergoing a rotator cuff repair at the same time as a shoulder replacement surgery, it eliminates the need for two surgeries.
After surgery, your arm will be kept in a sling so that your shoulder moves as little as possible to help in the healing process. While recovery can take a while, it’s important to follow all of your healthcare provider’s advice following surgery to help reduce the chance of complications.
Summary
Rotator cuff surgery and shoulder replacement surgery are viable options for shoulder injuries and pain. Shoulder replacement removes part or all of the shoulder joint to replace it with artificial implants, whereas rotator cuff surgery repairs tears or injuries.
How Long Is Recovery?
The entire recovery process for a shoulder replacement, including physical therapy, can take as long as six months. For rotator cuff surgery, recovery time is typically four to six months.
If the rotator cuff is damaged beyond repair, shoulder replacement surgery is not an option because the cuff is required to help hold the new joint in place. If the damage can be fixed, medical providers may opt for rotator cuff surgery before sending you for a total shoulder replacement. The procedures can also be combined to tackle damage to the shoulder joint and a rotator cuff injury.
As with other surgeries, there are side effects associated with both procedures. They can include pain and swelling in the area and limited movement capabilities. To ensure that recovery goes smoothly, people are advised to take pain medications as instructed and avoid movement as much as possible.
A Word From Verywell
Shoulder pain is highly common but that doesn’t make it any easier to cope with. When you have limited range of motion, even simple tasks can feel impossible. The good news is that there are options for you if you contend with this type of pain every day.
If you are experiencing any type of shoulder pain or injury, it may be worth it to explore surgical options with your medical care provider. In many people, surgery can fix the issue and restore complete function to the shoulder.
Frequently Asked Questions
- Does shoulder replacement surgery include rotator cuff repair?
- Not all shoulder replacement surgeries will include the repair of a damaged rotator cuff. This is because, if the rotator cuff is strong enough to hold the implants in place, the repair isn’t likely required. However, if the damage to the rotator cuff compromises the integrity of the joint replacement, the two procedures can be done simultaneously.
- Will I need shoulder replacement surgery after rotator cuff surgery?
- Not everyone who undergoes rotator cuff surgery will need to eventually have a shoulder replacement. However, in some cases, it is necessary. Your personal circumstances will dictate whether or not you’ll need one or both surgeries at some point in your life.
- Is shoulder replacement more painful than rotator cuff surgery?
- Pain is a likely side effect of both surgeries. However, the severity of the pain in shoulder replacement isn’t the same as it is with rotator cuff surgery. In fact, research has found that rotator cuff surgery, even though it is often less complicated, comes with more pain in the 24 hours after surgery is completed.
Not all shoulder replacement surgeries will include the repair of a damaged rotator cuff. This is because, if the rotator cuff is strong enough to hold the implants in place, the repair isn’t likely required. However, if the damage to the rotator cuff compromises the integrity of the joint replacement, the two procedures can be done simultaneously.
Not everyone who undergoes rotator cuff surgery will need to eventually have a shoulder replacement. However, in some cases, it is necessary. Your personal circumstances will dictate whether or not you’ll need one or both surgeries at some point in your life.
Pain is a likely side effect of both surgeries. However, the severity of the pain in shoulder replacement isn’t the same as it is with rotator cuff surgery. In fact, research has found that rotator cuff surgery, even though it is often less complicated, comes with more pain in the 24 hours after surgery is completed.
