Joint replacement surgery is generally considered for treatment of severely painful arthritic joints. The arthritis can sometimes be a primary problem such as rheumatoid arthritis or osteoarthritis or can sometimes be post-traumatic, following an injury which may have occurred some years before. Depending on the joint involved, the level of pain responsiveness to conservative treatment, total joint replacement surgery may need to be considered.
Total shoulder replacements are performed for both severely arthritic shoulders and sometimes for severe pain caused by chronic rotator cuff tear.
Total elbow replacement surgery is usually performed in patients with rheumatoid arthritis. Some patients with post-traumatic or osteoarthritis may benefit from elbow replacement surgery later in life.
Joint replacement surgery is sometimes considered for conditions in the hand and wrist, in particular the small joints of the fingers. Severe base of thumb arthritis is often managed with a form of excisional arthroplasty with ligament reconstruction and tendon intra-position. Joint replacement surgery may also play a role in some patients. Depending on the condition and the joint involved, sometimes joint fusion (arthrodesis) gives the best functional result.
Total shoulder replacements are performed for severe pain and disability as the result of osteoarthritis or rheumatoid arthritis. Sometimes chronic rotator cuff tears which are irreparable are best treated with reverse total shoulder replacements.