Total Shoulder Arthroplasty (TSA)

Shoulder pain can disrupt your daily life, limiting mobility and preventing you from enjoying activities you love. For those with severe shoulder pain caused by conditions like arthritis, rotator cuff injuries, or trauma, total shoulder arthroplasty (TSA) may be the solution. At Dr. Justin Chronister’s practice in Houston, you’ll receive expert care from a fellowship-trained, board-certified orthopedic surgeon specializing in advanced shoulder procedures.

What is total shoulder arthroplasty?

Total shoulder arthroplasty is a surgical procedure where damaged components of the shoulder joint are replaced with medical-grade implants, designed to mimic the function of a healthy shoulder. This procedure aims to relieve pain, restore mobility, and improve the overall quality of life.

During the TSA Procedure:

The humeral head (top of the arm bone) is replaced with a smooth, spherical implant secured to a stem inside the bone.

The shoulder socket (glenoid) is lined with a durable polyethylene component, often fixed with bone cement for stability.

Advanced surgical tools guide the removal of arthritic bone and ensure precise implant placement for optimal function.

For TSA to succeed, the surrounding soft tissues, including the rotator cuff, must be healthy enough to support the joint. During your consultation, Dr. Chronister will carefully evaluate your condition and recommend the most appropriate treatment options for your needs.

Common Causes of Shoulder Pain

Osteoarthritis (OA) is sometimes called degenerative arthritis because it is a "wearing out" condition involving the breakdown of cartilage and bones. With osteoarthritis, the cushioning cartilage at the end of the humerus may have worn down, making shoulder movement painful as bone rubs against bone.

Shoulder OA commonly occurs many years following a shoulder injury, such as a dislocation, that has led to joint instability and repeated shoulder dislocations ‐ damaging the shoulder to the point that OA develops.

Post-Traumatic arthritis may develop after an injury to the shoulder joint in which the bone and cartilage do not heal properly. The joint is no longer smooth and scar tissue develops. The scar tissue causes pain in the shoulder joint.

Cuff tear arthropathy may develop after a significant injury to the rotator cuff muscle(s). In the presence of cuff tear arthropathy, multiple bony and soft tissue changes are present, which may decrease the function and strength of your arm.

Rheumatoid Arthritis (RA) is an autoimmune disease in which the body's immune response negatively affects the lining of the joints (called the synovial membrane), causing chronic inflammation and pain. The synovium becomes thickened and inflamed. In turn, too much synovial fluid is produced within the joint space, which causes a chronic inflammation that damages the cartilage, and wears out the ball and socket. This results in cartilage loss, pain, and stiffness.

Avascular Necrosis (AVN) results when bone is deprived of its normal blood supply. Without proper nutrition from the blood, the bone's structure weakens, may collapse and damage the cartilage. Since this is most often seen at the ends of bones, your joints may be greatly affected. This is especially true of the shoulder joint and most commonly appears at the top end of the upper arm bone, the long bone that extends from the elbow to the shoulder.

Exploring Treatment Options for Shoulder Pain

Every patient’s journey is unique. Dr. Chronister prioritizes conservative treatments first, which may include:

Rest and activity modification

Physical therapy

Medications or steroid injections

If non-surgical methods do not provide sufficient relief, shoulder replacement surgery may be recommended. Dr. Chronister offers tailored solutions, including:

Total Shoulder Arthroplasty (TSA): Replacing the ball and socket for comprehensive joint restoration.

Reverse Shoulder Arthroplasty (RSA): An option for patients with severe rotator cuff damage.

Hemiarthroplasty: Partial shoulder replacement for specific conditions like avascular necrosis.

Both, a TSA and RSA are intended to relieve pain and restore some function in the shoulder. The surgical approach, or incision for a TSA and RSA are very similar and involve the restoration of the ball (humeral head) and socket (glenoid implant). Alternatively, in other surgical options such as Hemiarthroplasty (or partial shoulder replacement) only the humeral head is replaced, typically for specific conditions such as avascular necrosis.

Shoulder implants are designed to enable the joint to mimic the movement of a healthy, functioning joint. When discussing shoulder replacement surgery with Dr. Chronister, he will outline the different surgical techniques and explain your options to effectively address your joint pain.

Why Choose Dr. Justin Chronister for Shoulder Surgery in Houston?

Dr. Chronister is a trusted name in orthopedic surgery with a patient-centered approach to care. With fellowship training from the prestigious Andrews Sports Medicine Center, Dr. Chronister specializes in advanced, minimally invasive techniques for shoulder and joint preservation. His patient-centered approach includes care plans that fit your lifestyle and provide access to top joint centers in Houston, including Memorial Hermann Memorial City and Greater Heights Hospital.

Whether you're considering total shoulder arthroplasty (TSA) or exploring other options, Dr. Chronister's expertise and compassionate team are here to guide you. Schedule your consultation today and take the first step toward lasting relief.

Trusted Resources and References

The Arthritis Foundation. What is Osteoarthritis. https://www.arthritis.org/about-arthritis/types/osteoarthritis/.
Rotator cuff tear arthropathy: evaluation, diagnosis, and treatment: AAOS exhibit selection. Bone Joint Surg Am. 2012 Mar 21;94(6):e34. dos: 10.2106/JBJS.K.00746. Nam D, Maak TG, Raphael BS, Kepler CK, Cross MB, Warren RF. https://www.ncbi.nlm.nih.gov/pubmed/22438007.
The Mayo Clinic. Dislocated Shoulder. https://www.mayoclinic.org/diseases-conditions/avascular-necrosis/symptoms-causes/syc-20369859.
The Center for Disease Control and Prevention. Arthritis. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/arthritis.htm

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