Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

From a simple fall, I ended up with a broken arm and a torn rotator cuff. The surgeon is talking about me needing a joint replacement. Can't this just be repaired? Must I really lose a perfectly good joint? I don't have arthritis or anything like that.

Answer:

If your upper arm (called the humerus) was broken, you may be at risk for some serious complications. Avascular necrosis (AV) is the biggest problem. This is a loss of blood supply to the head of the humerus. Without enough oxygen and nutrients, the bone starts to die.

A severe rotator cuff tear (RCT) may not be something that can be repaired. If there is severe damage to the joint surface along with a RCT, shoulder replacement may be the best choice.

Patients with poor fracture healing, soft tissue imbalances, and collapse of the humeral head may have a poor result. If the shape of the humeral head changes, further imbalances will occur.

The farther the greater tuberosity is from the humeral head, the worse the prognosis. The greater tuberosity is a bump on the bone where tendons and ligaments attach.

If the break doesn't heal properly, a shift in the position of the greater tuberosity can result in loss of motion, pain, and poor patient satisfaction. It may be that a joint replacement is the best option for you. Ask your surgeon to explain your particular situation. Find out more about the reason for his or her advise to have a shoulder replacement. Mark Tauber, MD, et al. Shoulder Arthroplasty for Traumatic Avascular Necrosis. In Clinical Orthopaedics and Related Research. December 2007. Number 465. Pp. 208-214.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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