FAQs: Total Shoulder Replacement

What is a total shoulder replacement?

Total shoulder replacement is a surgical procedure to replace the damaged ball and socket joint of the shoulder with artificial components. The artificial parts are made of metal and plastic, and they are designed to mimic the natural movement of the shoulder joint.

Total shoulder replacement is a major surgery, but it is often very successful in relieving pain and improving function in the shoulder. The surgery typically takes 2-3 hours, and patients may go home the same day, or stay in the hospital for 1-2 days.

What are the different types of shoulder replacement procedures?

Anatomic total shoulder replacement: In this procedure, the ball and socket of the shoulder joint are both replaced. The ball is made of metal and the socket is made of plastic. The implants are designed to mimic the natural movement of the shoulder joint.

Reverse total shoulder replacement: This is the most common type of shoulder replacement. This type of shoulder replacement is used for people who have severe rotator cuff tears or insufficient glenoid bone stock. In this procedure, the socket and ball of the shoulder joint are switched. The ball is made of metal and the socket is made of plastic. The implants are designed to allow the deltoid muscle to lift the arm instead of the rotator cuff.

Partial shoulder replacement (hemiarthroplasty): This type of shoulder replacement is used for people who have damage to only one part of the shoulder joint. In this procedure, only the damaged part of the joint is replaced. The most common type of partial shoulder replacement is humeral head replacement. In this procedure, the ball of the humerus (upper arm bone) is replaced with a metal ball.

When is a shoulder replacement recommended?

Shoulder replacement surgery is recommended when other treatments for shoulder pain and limited range of motion have not been successful. Some of the conditions that may lead to shoulder replacement surgery include:

• Osteoarthritis: This is the most common cause of shoulder pain and limited range of motion. It is a condition that causes the cartilage in the shoulder joint to break down.
• Rotator cuff tear: This is a tear in the group of muscles and tendons that surround the shoulder joint. It can cause pain and limited range of motion in the shoulder.
• Fracture: A fracture of the humerus (upper arm bone) or the glenoid (socket of the shoulder joint) can sometimes require shoulder replacement surgery.
• Avascular necrosis: This is a condition that occurs when the blood supply to the shoulder joint is blocked. It can lead to pain and limited range of motion in the shoulder.
• Rheumatoid arthritis: This is an autoimmune disease that can affect any joint in the body, including the shoulder. It can cause pain, swelling, and limited range of motion in the shoulder.

Here are some signs that may indicate that you need a shoulder replacement:

• Severe pain in the shoulder that is not relieved by over-the-counter pain medication or physical therapy.
• Limited range of motion in the shoulder, making it difficult to perform activities of daily living such as dressing, bathing, or reaching overhead.
• Weakness in the shoulder that makes it difficult to lift your arm or use it to perform activities.
• Instability in the shoulder that makes it feel like your arm is going to come out of the socket.
• Cracking or popping noises in the shoulder when you move it.

If you are experiencing pain and limited range of motion in your shoulder, it is important to see a doctor. They can diagnose the cause of your pain and recommend the best treatment option for you. In some cases, shoulder replacement surgery may be the best option to relieve your pain and improve your range of motion.

What are the risks and complications of shoulder replacement?

Shoulder replacement surgery is a major surgery and, as with any surgery, there are risks and complications associated with it. Some of the most common risks and complications of shoulder replacement surgery include:

• Infection: Infection is a serious risk of any surgery, including shoulder replacement surgery. The risk of infection is typically low, but it can be serious if it does occur. Infection can lead to pain, swelling, redness, and warmth around the incision site. It can also lead to loosening of the implant and the need for further surgery.
• Bleeding: Bleeding is another risk of any surgery, including shoulder replacement surgery. The risk of bleeding is typically low, but it can be serious if it does occur. Bleeding can lead to blood clots, which can travel to the lungs or brain. It can also lead to a need for blood transfusion.
• Nerve damage: Nerve damage is a rare but serious risk of shoulder replacement surgery. Nerve damage can cause numbness, weakness, and pain in the shoulder and arm. It can also make it difficult to move the shoulder.
• Blood clots: Blood clots can form in the veins of the arm or leg after surgery. These blood clots can travel to the lungs, heart, or brain. Blood clots are a serious risk, but they can be prevented with medication.
• Implant failure: The implants used in shoulder replacement surgery can sometimes fail. This can lead to pain, instability, and the need for further surgery.
• Dislocation: The shoulder joint can sometimes dislocate after shoulder replacement surgery. This is more likely to happen if the patient has a history of shoulder dislocations. Dislocation can be painful and can require surgery to repair.
• Need for revision surgery: In some cases, it may be necessary to have revision surgery after shoulder replacement surgery. Revision surgery is surgery to replace or repair the implants that were used in the initial surgery. Revision surgery is more likely to be needed if the patient has had complications with their initial surgery.

Here are some things you can do to reduce the risk of complications from shoulder replacement surgery:

• Make sure you are a good candidate for surgery: Your doctor will assess your overall health and fitness to make sure you are a good candidate for surgery.
• Get regular physical therapy before and after surgery: Physical therapy can help to improve your range of motion and strength before surgery and help you recover from surgery more quickly.
• Take your medications as prescribed: Your doctor will prescribe antibiotics to help prevent infection and pain medication to help control your pain. It is important to take your medications as prescribed to reduce the risk of complications.
• Follow your doctor's instructions carefully: Your doctor will give you specific instructions on how to care for your shoulder after surgery. It is important to follow these instructions carefully to reduce the risk of complications.

It is important to discuss the risks and complications of shoulder replacement surgery with your doctor before you decide to have the surgery. Your doctor can help you understand the risks and benefits of surgery and decide if it is the right option for you.

What can you expect before, during, and after shoulder replacement surgery?

Before surgery:

• You will meet with your doctor to discuss the surgery and your expectations.
• You will have blood tests and other tests to make sure you are healthy enough for surgery.
• You will be given instructions on how to prepare for surgery, such as not eating or drinking anything after midnight the night before surgery.
• You may be given antibiotics to take before surgery to help prevent infection.

During surgery:

• You will be given general anesthesia, which will put you to sleep during the surgery.
• Your surgeon will make an incision in your shoulder and replace the damaged parts of the joint with artificial implants.
• The surgery typically takes 2-3 hours.

After surgery:

• You will wake up in the recovery room with a bandage on your incision and your arm in a sling.
• You may have a pain pump in your arm to deliver pain medication.
• You will be given instructions on how to care for your shoulder after surgery.
• You may return home the same day or stay in the hospital for 1-2 days after surgery.

At home:

• You will need to wear a sling for 2-4 weeks after surgery.
• You will need to do physical therapy exercises to help you regain range of motion and strength in your shoulder.
• You will need to avoid lifting anything heavy or doing any strenuous activities for 6-8 weeks after surgery.

How long does it take to recover from shoulder replacement surgery?

The recovery time for shoulder replacement surgery varies from person to person. Most people are able to return to their normal activities within 6 months of surgery. However, some people may need more time to recover.

Here is a general timeline of what to expect during your recovery:

• Days 1-4: You will likely be in the hospital for 1-2 days after surgery. You will need to wear a sling to keep your arm immobilized. You may also have a pain pump in your arm to deliver pain medication.
• Weeks 1-2: You will still need to wear a sling, but you may be able to start doing some gentle range of motion exercises. You will also start physical therapy.
• Weeks 3-6: You will continue with physical therapy and gradually increase the range of motion and strength in your shoulder. You may be able to start doing some light activities, such as walking or driving.
• Weeks 6-8: You should be able to return to most of your normal activities. However, you should still avoid lifting anything heavy or doing any strenuous activities.
• Months 3-6: You should be able to return to all of your normal activities. However, it may take up to a year for your shoulder to fully recover.

It is important to follow your doctor's instructions carefully after shoulder replacement surgery. This will help you recover as quickly and safely as possible.

Here are some additional tips for recovering from shoulder replacement surgery:

• Get plenty of rest.
• Eat a healthy diet.
• Stay hydrated.
• Take your medications as prescribed.
• Do your physical therapy exercises as instructed.
• Avoid lifting anything heavy or doing any strenuous activities.
• Be patient. It takes time to recover from shoulder replacement surgery.

If you have any questions or concerns about your recovery, be sure to talk to your doctor.

What results can one expect from total shoulder replacement surgery?

The results of shoulder replacement surgery can vary from person to person, but most people experience significant pain relief and improved range of motion after surgery.

Here are some of the results you can expect from shoulder replacement surgery:

• Pain relief: Most people experience significant pain relief after shoulder replacement surgery. Pain relief is usually immediate, but it may take a few weeks for the pain to completely subside.
• Improved range of motion: Shoulder replacement surgery can help to improve the range of motion in your shoulder. This can make it easier to perform activities of daily living, such as dressing, bathing, and reaching overhead.
• Improved strength: Shoulder replacement surgery can also help to improve the strength in your shoulder. This can make it easier to lift objects and participate in activities that require upper body strength.
• Improved quality of life: Shoulder replacement surgery can significantly improve your quality of life. You may be able to return to your hobbies and activities that you enjoy. You may also experience less pain and have an easier time performing everyday tasks.

It is important to note that not everyone experiences the same results from shoulder replacement surgery. Some people may experience complications or may not have as much improvement in their pain or range of motion as others. However, most people who have shoulder replacement surgery are satisfied with the results.

If you are considering total shoulder replacement, it is important to talk to your doctor about the risks and benefits of the surgery. You should also make sure that you are a good candidate for surgery. Some factors that may affect your candidacy for surgery include your age, overall health, and activity level. Your doctor can help you decide if shoulder replacement surgery is the right option for you.