Shoulder Replacement

When should it be considered?

Although performed less often than hip or knee replacement, shoulder replacements can restore quality of life for those with limited shoulder function due to pain or mechanical impairment. If you and your doctor have concluded that all medical treatments have been unsuccessful in controlling pain, or that your motion and function are so restricted that your quality of life is decreased, a shoulder replacement may be needed.

How to prepare for surgery.

As you prepare for the surgery you should educate yourself about the procedure. Knowing what to expect can ease many fears and make recovery much smoother. If possible, find someone who has had the surgery to talk to.?

You will be essentially “one armed” for several weeks following the procedure. Anything you can do at home to make things more accessible will help you during your recovery.

Plan on having some help at home for the first several days after your discharge. You may find many activities of daily living to be nearly impossible to do alone.?

Blood transfusions are often needed after surgery. Ask if you are a candidate for autologous blood donation, this means storing your own blood for transfusion. It is generally suggested you store 1-2 units of blood. The first donation must be given within 42 days of the surgery and the last, no less than seven days before your surgery.

What happens during the surgery?

You will be given a general or local anesthesia. An incision will be made, that runs across the front of the shoulder from the middle of the collarbone to the middle of the arm bone. Any noticeable scar tissue that may impair movement is removed.?

The end of the humerous (arm bone) is cut using a saw. The removed bone may be used as bone graft to assist with the placement of the implant. The shoulder blade is then prepared for the placement of the artificial socket. Cement may or may not be used to hold the artificial parts in place. The surgery usually takes 2-3 hours.

What happens after surgery?

You will wake up with a bulky dressing on your shoulder. A drainage tube may be in place to drain excess fluid from the operative site. A continuous passive motion (CPM) machine may be used to move the shoulder for the first few days to decrease the possibility of stiffness.?

Pain medication will be given as needed during your hospital stay. Physical therapy will begin late the day of surgery or the following day and begins with moving the fingers, wrist and elbow. Some motion of the shoulder is begun within a day or so after surgery. The physical therapist will show you a program of exercises to do at home. The average hospital stay is from three to five days.?

Before discharge you will be given very specific instructions. The best surgeon in the world does not mean a successful recovery, YOU are responsible for your recovery. Follow all instructions and do your exercises faithfully.?

Some of the normal home-going instructions include:

The incision can get wet in the shower but no baths are recommended for 3 weeks.?

Keep the shoulder dressing in place
until instructed otherwise by your doctor.

Wear elastic stockings (TEDS) until your follow-up appointment or as directed by your doctor.

Keep the incision clean and dry. If any swelling, increased pain, drainage from the incision site, redness around the incision, or fever is noticed, report this immediately to the doctor.?

What is the expected outcome of a hip replacement?

A shoulder replacement is usually very successful for pain relief. The joint may not function as well as a healthy, normal joint, however it is usually functions much better than the pre-surgery diseased joint.?

What complications may occur?

The risks of this procedure may include infection, injury to nerves and blood vessels, fracture, stiffness or instability of the joint, loosening of the artificial parts, failure of the rotator cuff, pain, and the need for additional surgeries.

For more information:

About Shoulder Replacement Arthroplasty?
Patient’s Guide to Shoulder Replacement
Shoulder Replacement Surgery?

References:
University of Washington, About Shoulder Replacement Arthroplasty
John Hopkins, Patient’s Guide to Shoulder Replacement