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When I was 16 years old, I had a pretty bad football injury to my left shoulder. Now at 28, I have limited shoulder motion and constant pain. The surgeon I saw has suggested a procedure called shoulder resurfacing. What can you tell me about it?

Joint resurfacing has been around for almost 30 years. Instead of removing bone and replacing the joint, the surface of the bone is smoothed over and capped with a metal component.This treatment technique has been proven safe and effective for both the hip and the shoulder. Shoulder resurfacing is fairly new and becoming more popular. With joint resurfacing, there is less bone destroyed and fewer fractures. Best of all, the patient can still convert to a total joint if needed later. Surgeons have several implant designs to choose from when performing a shoulder resurfacing procedure. The implants are made of cobalt-chromium or titanium-alloy. Some have a ceramic surface coating. Others provide a titanium porous (with holes) coating on the undersurface where the implant rests against the bone. The advantage of a porous surface is that the body can fill in the holes with bone to help cement the implant-joint interface together. A recent development in shoulder resurfacing is the use of an implant that looks like a giant screw. This method allows for partial resurfacing of the humeral head (round ball at the top of the upper arm). It is used for patients who have smaller defects in the humeral head but don't really need the entire surface smoothed and capped. Not everyone is a good candidate for shoulder resurfacing. Patients who benefit most are those with pain from arthritis who have completed a program of physical therapy with little or no change in their painful symptoms and function. Resurfacing is particularly attractive for younger, more active adults like yourself. Only short-term results have been published so far for shoulder resurfacing. But they show that 90 per cent of the patients report significant improvements in motion, pain, and strength. All of that leads to better function in daily activities, leisure activities, and sports participation. Patients say they can do just about anything they want from yoga to golf to mountain biking, hockey, even power lifting. Compared with a total shoulder replacement, there are fewer complications and problems after shoulder resurfacing. Operative time is shorter and fewer days in the hospital are typical with shoulder resurfacing compared with joint replacement. There's also less blood loss. And, of course, the main advantage is the availability of treatment for young, active patients who are limited by their pain.

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