Total Shoulder Arthroplasty

Joint replacement surgeries are common, and increasing due to aging baby boomers, improved diagnosis and treatment of arthritis and patient demands for improved mobility and quality of life. In addition, younger patients are seeking joint replacement in the desire to improve quality of life. In all cases patients have the opportunity to improve mobility despite advanced arthritis.

TSA patients have fewer complications, and shorter hospital stays than knee or hip replacement patients. TSA provides long – term satisfaction rates of 86-95%.

Total Shoulder Arthroplasty is shoulder joint replacement surgery. In this surgery, the damaged shoulder joint bones are replaced with artificial joint parts. TSA is the gold standard treatment for end stage arthritis of the shoulder where there is an extreme loss of motion and significant pain. About 60% of total shoulder replacements are due to osteoarthritis. The other 40% are due to various conditions including rheumatoid arthritis, post-traumatic arthritis, Severe rotator cuff tears that lead to arthritis and destruction of the cartilage in the joint, severe fractures and other conditions.

When a patient suffers with a severe shoulder condition and symptoms have failed to resolve with conservative treatments, shoulder replacement surgery offers the patient the opportunity for incredible pain relief, and restored range of motion, so they can enjoy their daily activities.

Minimally invasive TSA is an extremely technical surgery. Dr. Walter A. Thomas, Board-certified Orthopedic surgeon and Fellowship Trained in Sports Medicine and Arthroscopic Surgery, has the knowledge, skills and expertise, and has successfully performed hundreds of TSAs.

Dr. Thomas may recommend TSA surgery based on your medical history, a physical exam, X-rays and other tests to assess the condition of your bones and soft tissues. He will review with you the results of your assessment.

If your rotator cuff is healthy and working well a TSA will provide the best results. Other considerations are the nerve supply to your shoulder and the rotator cuff, and the state of your bone health.

The shoulder is a ball and socket joint. The head of the upper arm bone fits into the socket in the shoulder blade called the glenoid. All the bone surfaces are covered with cartilage, that protects the bones and allows for smooth, easy movement. Surrounding the joint are the muscles and tendons which provide support and stability. Together these structures permit the shoulder the greatest range of motion of any joint in the body.

The surgery will replace the arthritic joints with prostheses. There are three components:

  • The upper arm bone (humerus) called the ball.
  • The glenoid cavity in the scapula (Shoulder blade), and
  • The clavicle or collarbone

Conventional total shoulder replacement surgery takes several hours, and often requires an overnight hospital stay.

Open or conventional TSA or Minimally invasive TSA

Minimally invasive TSA allows the surgery to be performed as an outpatient, with small incisions, and without moving or cutting any tendons or the rotator cuff. This technique The advantages of this approach include:

  • Less cutting of soft tissues which helps avoid complications
  • Since the rotator cuff remains intact there are few activity restrictions
  • Less bleeding
  • Smaller incisions and scars- under 2 inches vs. open or conventional incision of almost 7 inches
  • Faster recovery
  • Less pain
  • Fewer complications

Who would benefit from total shoulder replacement?

  • People who have severe shoulder pain that interferes with ordinary activities such as reaching, dressing, washing and independent toileting.
  • People who have moderate to severe pain while at rest, that can interfere with sleep.
  • People who have a loss of motion and weakness in the shoulder.
  • People who have been unable to find substantial improvement with noninvasive therapies.


For patients in and near Thousand Oaks, California who are in pain due to an injury or arthritis, Dr. Walter Thomas, MD can help. He is a compassionate, kind and caring orthopedic surgeon who will treat you as if you were a member of his family. Dr. Thomas emphasizes injury prevention, and will educate you so you can return to your sport of choice at the highest level of play. His goal is to get you back to your passion, whether sports or chasing after your children.

Schedule a consultation with Dr. Walter A. Thomas and find out how you can get relief today. Call us at 805- 497-0817.