York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement

Total Shoulder Replacement

Osteoarthritis in the shoulder occurs when the cartilage that lines the shoulder joint wears away. Arthritis can cause many different symptoms, including stiffness, pain, and catching. In those patients who fail non-surgical management, Dr. Welch may recommend a total shoulder replacement. During shoulder replacement surgery, Dr. Welch resurfaces the degraded ends of each side of the shoulder with metal and plastic components. The goal of surgery is to provide smooth, painless shoulder range of motion. This surgery is considered very reliable; studies have revealed that most patients have a good outcome. However, shoulder replacement surgery does not last forever. Most surgeons agree that the average lifespan of a shoulder replacement is approximately 15-25 years. Therefore, in younger patients with severe arthritis, Dr. Welch may recommend a joint preserving procedure instead of a shoulder replacement.

In patients who have severe shoulder arthritis and a torn rotator cuff (rotator cuff arthropathy), Dr. Welch may recommend a special type of shoulder replacement – a “reverse shoulder replacement.” Unlike a total shoulder replacement, which relies on the rotator cuff tendons to keep the shoulder stable, a reverse shoulder replacement relies on the deltoid muscle to stabilize the shoulder. During a reverse shoulder replacement, a metal ball is placed on the socket (glenoid) and a metal/plastic socket is placed on the proximal humerus. This “reversal” changes the mechanics in the shoulder joint, allowing patients to have stable, usually painless shoulder motion without having a healthy rotator cuff.

Post-Operative Rehabilitation

Following surgery, patients are given a sling for comfort. Dr. Welch recommends intermittent icing and gentle range of motion following surgery. Dr. Welch also recommends starting physical therapy approximately 2-4 weeks after surgery. Physical therapy focuses on reducing swelling in the shoulder, restoring full range of motion, and maintaining strength in the shoulder. It is important to avoid certain shoulder positions and certain exercises during the recovery period.