What is total shoulder replacement?

Total shoulder replacement is surgery to replace damaged parts of the shoulder joint with artificial parts.

Total shoulder replacement surgery allows most patients to have less pain and stiffness and more range of motion at the shoulder joint. The surgery is often used to treat severe pain caused by:

  • Osteoarthritis
  • Rheumatoid arthritis
  • A badly broken upper arm bone
  • Shoulder joint tissue damage
  • A tumor

What are the risks and/or side effects?

Possible risks or complications of total shoulder replacement surgery include:

  • Infection. This is a possible complication of any surgery. Minor infections can be treated with antibiotic medicine. Major infections may require surgery.
  • Nerve injury. Though rare, nerves near the shoulder joint may be damaged during surgery. These injuries usually improve with time.
  • Prosthesis trouble. Sometimes, the artificial parts can wear out and break down. A prosthesis can also dislocate. Surgery is often recommended to fix these problems.

The risk of problems after a joint replacement surgery is much lower now compared to several years ago.

What are the benefits?

Benefits of total shoulder replacement surgery include:

  • Reduced shoulder pain.
  • Ability to perform certain normal activities easier, such as reaching for things, dressing, washing, and using the bathroom.
  • Ability to return to sports, such as golf, swimming, bowling, and others.
  • Better sleep.
  • Stronger shoulder.
  • Repairing a damaged shoulder when medicine and/or physical therapy didn’t work.

How do I prepare?

You can prepare for a total shoulder replacement surgery by:

  • Having an evaluation. Your orthopedic surgeon may have you complete a medical evaluation with your primary care doctor before your surgery. Your primary care doctor will check if you are healthy enough for surgery.
  • Discussing medicines. Talk with your doctor about the medicines you take. You may need to stop taking some of them before surgery, especially if they include non-steroidal anti-inflammatory medicines like aspirin, ibuprofen, and naproxen. If you take prescription blood-thinner medicines, like warfarin (Coumadin), be sure to tell your doctor.
  • Preparing your home. Since it may be hard to reach high areas during recovery, be sure to place important items in lower areas. You may also need someone to assist you with dressing, bathing, cooking, and other household tasks. If you won’t have this support at home, you may need to stay in a rehab facility until you feel like you can take care of yourself.

How is it done or administered?

You will receive 1 of 2 types of anesthesia before total joint replacement surgery:

  1. General anesthesia. General anesthesia will make you unconscious and unable to feel any pain during surgery.
  2. Regional anesthesia. This type of anesthesia numbs your arm and shoulder area only. You will also be given medicine to help you relax during the surgery.

During surgery your doctor will:

  • Make an incision (cut) over your shoulder area
  • Remove the rounded end of your upper arm bone
  • Use a special cement to stick the new metal part to the bone
  • Smooth the end of the shoulder blade and glue a new end in place
  • Close up your incision with stitches or staples
  • Place a dressing (bandage) over the closed incision

Sometimes, doctors will place a tube in the area to help drain extra fluid. The tube will be removed when the fluid stops building up in the shoulder joint.

Total shoulder replacement surgery generally takes 1 to 3 hours to complete.

When will I know the results?

Once you recover from the anesthesia, your doctor will tell you about the surgery. You may not know the overall results until several weeks or months have passed. During that time, it is very important to follow all of your discharge instructions to make sure your recovery is as good as possible.

What are follow-up requirements and options?

After total shoulder replacement surgery:

  • You may need to stay in the hospital for 1 to 3 days
  • You may receive physical therapy to prevent shoulder stiffness
  • A physical therapist will teach you proper movements to do during recovery
  • Your arm will be placed in a sling for 2 to 6 weeks
  • You will be given instructions about how to care for yourself at home, including managing your pain
  • You will be given instructions about safe shoulder exercises to do on your own
  • You will generally need 4 to 6 months to recover

Artificial joints can wear out after many years. However, good personal care, exercise, and proper movement will go a long way to preserve your new joint as long as possible.

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