Shoulder Joint Replacement surgery

Overview

Shoulder replacement surgery involves removing damaged areas of your shoulder and replacing them with artificial parts. The procedure is performed to relieve pain and improve mobility. You might need a shoulder replacement if you have severe arthritis or a fracture in your shoulder joint.

Shoulder replacement surgery is usually recommended for people who have severe pain in their shoulder and have found little or no relief from more conservative treatments.

Some conditions that may require a shoulder replacement include:

  • Osteoarthritis. This type of arthritis is common in older people. It occurs when the cartilage that pads bones wears away
  • Rheumatoid arthritis (RA). With RA, your immune system mistakenly attacks your joints, causing pain and inflammation
  • Avascular necrosis. This condition happens when loss of blood to a bone occurs. It can cause damage and pain in the shoulder joint
  • A broken shoulder. If you badly break your shoulder bone, you might need a shoulder replacement to repair it

Your doctor can help you decide if shoulder replacement surgery is the best option for you.

People who have good results with shoulder surgery commonly have:

  • weakness or loss of motion in the shoulder
  • severe pain in the shoulder that interferes with everyday life
  • pain while resting or during sleep
  • little or no improvement after trying more conservative therapies, such as medications, injections, or physical therapy

This type of surgery is less successful in people with:

  • Diabetes
  • Depression
  • Obesity
  • Parkinson’s disease

How to prepare for surgery:

Several weeks before your procedure, your doctor may suggest that you have a complete physical exam to determine if you’re healthy enough for surgery.

You might need to stop taking certain medications a couple of weeks before the shoulder replacement. Some medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) and arthritis therapies, can cause too much bleeding. Your physician will also tell you to stop taking blood thinners.

On the day of your procedure, it’s a good idea to wear loose-fitting clothing and a button-up shirt.

You’ll probably stay in the hospital for 2 or 3 days after surgery. Since driving is only recommended after you’ve regained normal motion and strength in your shoulder, you should arrange for someone to take you home from the hospital.

Most people require some assistance for about six weeks after surgery.

What happens during the procedure?

Shoulder replacement surgery typically takes about two hours. You might receive general anesthesia, which means you’ll be unconscious during the procedure, or regional anesthesia, which means you’ll be awake but sedated.

During the surgery, doctors replace the damaged joint “ball,” known as the humeral head, of the shoulder with a metal ball. They also place a plastic surface on the “socket” of the shoulder, known as the glenoid.

Sometimes, a partial shoulder replacement can be performed. This involves replacing only the ball of the joint.

After your procedure, you’ll be taken to a recovery room for several hours. When you wake up, you’ll be moved to a hospital room.

Recovery:

Shoulder replacement surgery is a major operation, so you’ll likely experience pain during your recovery. You might be given pain medications by injection right after your procedure.

A day or so following the surgery, your doctor or nurse will give you oral drugs to ease the discomfort.

Rehabilitation is started right away, usually on the day of surgery. Your healthcare staff will have you up and moving as soon as possible.

After a couple of days you’ll be discharged from the hospital. When you leave, your arm will be in a sling, which you’ll wear for about 2 to 4 weeks.

You should be prepared to have less arm function for about a month after surgery. You’ll need to be careful not to lift any objects that are heavier than 1 pound. You should also avoid activities that require pushing or pulling.

In general, most people are able to resume gentle daily living activities within two to six weeks. You might not be able to drive for about six weeks if the surgery was done on your right shoulder for people who drive on the right side of the road, or your left shoulder for those that drive on the left side of the road.

It’s important to perform all home exercises that your healthcare provider recommends. Over time, you will gain strength in your shoulder.

It will take about six months before you can expect to return to more vigorous activities, such as golfing or swimming.

Complications:

As with any surgery, a shoulder replacement carries risks. Though the complication rate after surgery is less than 5 percent, you could experience:

  • Infection
  • A reaction to anesthesia
  • Nerve or blood vessel damage
  • Rotator cuff tear
  • Fracture
  • Loosening or dislocation of the replacement components

How long will shoulder replacement last?

It’s difficult to say just how long your shoulder replacement will last. Experts estimate that most modern shoulder replacements will last for at least 15 to 20 years.