Shoulder Replacement Surgery in Singapore
Shoulder replacement (arthroplasty) is surgery for advanced shoulder arthritis that aims to relieve persistent pain and improve movement when non-surgical treatment has provided insufficient relief. This procedure involves the removal of damaged bone and joint surfaces and their replacement with artificial components known as prostheses. At Gleneagles Hospital and Mount Alvernia Hospital in Singapore, orthopaedic surgeon Dr Poh Keng Soon assesses shoulder arthritis and discusses treatment options, including corticosteroid injections and, where appropriate, anatomical or reverse shoulder replacement surgery.
When Is Shoulder Replacement Recommended?
Shoulder replacement may be considered when persistent pain, stiffness and restricted movement interfere with sleep, dressing, reaching overhead or lifting the arm, despite non-surgical treatment. Dr. Poh will assess the extent of joint damage, rotator cuff function and previous treatment when determining whether surgery is suitable.
Shoulder conditions for which joint replacement may be considered include:
• Osteoarthritis: Progressive loss of cartilage in the shoulder joint that can eventually cause painful bone-on-bone contact and limited movement.
• Rheumatoid Arthritis: An inflammatory joint condition that can damage cartilage and surrounding tissues, resulting in pain and reduced shoulder mobility.
• Post-Traumatic Arthritis: Joint deterioration following an earlier shoulder injury, such as a fracture or dislocation.
• Avascular Necrosis (AVN): Disruption of blood supply to the humeral head, potentially causing bone collapse and damage to the joint surface.
• Cuff Tear Arthropathy: Arthritis that develops following a long-standing, large rotator cuff tear. Without adequate tendon support, the humeral head may migrate upwards and rub against the acromion, contributing to joint damage. Reverse shoulder replacement may be considered when the rotator cuff is irreparably damaged.
• Severe Shoulder Fractures: Shoulder replacement may be considered for selected displaced or complex fractures of the upper humerus, depending on the fracture pattern and suitability for surgical fixation.
Shoulder Arthritis Treatment Before Shoulder Replacement
Dr. Poh may recommend the following treatments to manage shoulder arthritis before discussing joint replacement surgery:
• Pain Relief: Oral medication, medicated gels or patches, and ice or heat packs to manage symptoms.
• Physiotherapy: Guided exercises to maintain shoulder mobility and muscle strength.
• Activity Modification: Adjusting movements that aggravate shoulder pain.
• Corticosteroid Injections: May help reduce inflammation and pain in the affected joint.
• Arthroscopic Debridement: Keyhole surgery to remove loose tissue, cartilage fragments or loose bodies in selected cases of mild arthritis.
Corticosteroid injections and arthroscopic debridement may relieve symptoms, but neither reverses cartilage damage nor stops arthritis from progressing.
Types of Shoulder Replacement
There are several types of shoulder replacement surgeries, each suited to different conditions and patient needs:
Hemiarthroplasty (Partial Shoulder Replacement)
In hemiarthroplasty, only the damaged or diseased humeral head (the ball of the shoulder joint) is replaced with a metal implant, while the natural socket (glenoid) is preserved. Hemiarthroplasty may be an option in selected cases where damage mainly affects the humeral head and the natural glenoid socket can be preserved.
Anatomical Total Shoulder Replacement (aTSA)
An aTSA involves replacing both the humeral head and the glenoid with prosthetic components designed to mimic the natural anatomy of the shoulder joint. This procedure is suitable for patients with arthritis affecting both joint surfaces when the rotator cuff tendons can adequately support shoulder movement.
Reverse Shoulder Replacement (RSA)
Reverse shoulder replacement switches the positions of the ball and socket, with a metal ball attached to the glenoid and a plastic socket attached to the humerus. This allows the deltoid muscle to assist with arm elevation when the rotator cuff cannot function adequately. Dr. Poh performs reverse shoulder replacement for selected patients with cuff tear arthropathy, where long-standing rotator cuff damage is associated with shoulder arthritis.
Comparison of Shoulder Replacement Procedures
Planning the Shoulder Replacement Surgery
Dr. Poh uses computer-assisted planning and 3D-printed, patient-specific instruments to guide shoulder implant placement based on the patient's joint anatomy. This approach is also used in cases involving significant bone deformity or bone loss associated with advanced shoulder arthritis.
What Happens During Shoulder Replacement Surgery
Shoulder replacement surgeries are typically performed as day procedures or with a short hospital stay of one night. During the surgery, the orthopaedic surgeon makes an incision to access the shoulder joint. The damaged bone and cartilage are then removed, and the prosthetic components are implanted securely into the bone. Once the components are in place, the incision is closed, and the surgical site is bandaged.
Anaesthesia may involve general anaesthesia, a regional nerve block or a combination of both, depending on the procedure and individual circumstances.
Recovery After Shoulder Replacement
After the surgery, patients typically undergo a period of postoperative rehabilitation to regain strength, flexibility, and function in the shoulder. Rehabilitation may include gentle exercises, physical therapy, and gradually increasing the range of motion of the shoulder joint. The duration and intensity of rehabilitation will vary depending on the individual's condition and the type of surgery performed.
Recovery may involve the following stages:
1. Sling and Protected Movement: Sling use depends on the condition and type of shoulder replacement performed. Routine reverse shoulder replacement generally does not require a sling, while anatomical replacement and more complex procedures may require 4–6 weeks of protected movement.
2. Physiotherapy to Regain Movement: Follow guided exercises to restore shoulder mobility within the recommended postoperative restrictions.
3. Rebuilding Strength: Gradually strengthen the deltoid and surrounding shoulder muscles according to the replacement type and recovery progress.
4. Returning to Daily Activities, Driving and Work: Resume activities according to shoulder movement, strength and functional recovery. Driving should only resume when medical restrictions allow and you can safely control the vehicle.
5. Lifting and Sporting Activities: Discuss appropriate lifting limits, overhead movements and sporting activities with Dr. Poh before resuming physically demanding activities.
Shoulder replacement surgery aims to reduce arthritis-related pain and improve joint function. Recovery varies according to factors such as age, pre-existing medical conditions, severity of shoulder damage and the type of surgery performed.
Risks and Complications of Shoulder Replacement
Like all surgical procedures, shoulder replacement carries potential risks and complications, including:
• Infection: Infection may develop at the surgical site or around the implanted joint.
• Shoulder Stiffness: Restricted shoulder movement may persist following surgery.
• Joint Instability or Dislocation: The artificial shoulder joint may become unstable or dislocate.
• Nerve Injury: Nerves surrounding the shoulder may be affected during surgery.
• Implant Loosening or Wear: Prosthetic components may loosen or wear over time, potentially requiring revision surgery.
• Fracture Around the Implant: The bone surrounding the prosthetic components may fracture during or after surgery.
Dr. Poh will discuss the potential risks associated with your recommended shoulder replacement procedure during your consultation.
Shoulder Replacement Surgery With Dr Poh Keng Soon
For shoulder replacement surgery in Singapore, Dr. Poh Keng Soon provides consultations for shoulder arthritis and related joint conditions, including assessment for anatomical total shoulder replacement and reverse shoulder replacement. His clinical background includes subspecialty fellowship training in sports, shoulder and elbow surgery in Melbourne, Australia, where he managed shoulder and elbow injuries among professional athletes.
Qualifications & Professional Background
• Medical Qualifications: MRCS (Edinburgh, 2013), MMed (Orthopaedic Surgery, NUS, 2017) and FRCS (Edinburgh, 2018).
• Subspecialty Fellowship: Completed under the Ministry of Health's Health Manpower Development Plan (HMDP) award in Melbourne, Australia.
• Clinical & Academic Appointments: Visiting Consultant at National University Hospital and Adjunct Assistant Professor at NUS Yong Loo Lin School of Medicine.
• Hospitals and Day Surgery Centres: Accredited to perform surgery at Gleneagles, Mount Elizabeth, Mount Elizabeth Novena, Parkway East, Mount Alvernia, Farrer Park, Thomson Medical Centre, Cura Day Surgery, Aptus Surgery Centre and Novaptus Surgery Centre.
Frequently asked questions
Clinic Locations
Gleneagles Hospital
Orthopaedic and Hand Surgery Partners
#03-37 Annexe Block
6A Napier Road
Singapore 258500
Opening Hours:
Monday to Friday: 9:00 AM – 5:30 PM
Saturday: 9:00 AM – 12:30 PM
Sunday & Public Holidays: Closed
Mount Alvernia Hospital
Orthopaedic and Hand Surgery Partners
#06-08 Medical Center A
820 Thomson Road
Singapore 574623
Operating Hours:
Monday to Friday: 9:00 AM – 5:30 PM
Saturday: 9:00 AM – 12:30 PM
Sunday & Public Holidays: Closed
Tel: +65-6970 7748
Mobile/WhatsApp: +65 8129 1019
