Shoulder Replacement Surgery
Total shoulder replacement (arthroplasty) is a surgical procedure where portions of the shoulder joint are removed and replaced with artificial implants to reduce pain and restore range of rotation and mobility. This surgery is very successful for treating the severe pain and stiffness caused by arthritic changes within the shoulder joint.
Shoulder arthritis is a condition in which the smooth cartilage that covers of the bones of the shoulder degenerate or disintegrate. In a healthy shoulder, these cartilage surfaces permit the bones to comfortably glide against one another. When these cartilage surfaces disappear, the bones come into direct contact, increasing friction and causing them to roughen and damage each other. Bone-on bone movement can be quite painful and difficult. Surgically implanted artificial replacement surfaces restore pain-free movement, strength and function in the shoulder joint.
At Aptiva Health, we offer same-day and walk-in appointments for shoulder injuries and conditions to evaluate, diagnose, and make the appropriate referral for additional treatment based upon your specific shoulder injury or condition. We treat spine injuries and conditions in our Sports Medicine, General Medicine, Orthopedics, and Physical Therapy departments.
Shoulder Replacement Surgery
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.
conventional shoulder replacement v. reverse shoulder replacement
In a conventional shoulder replacement, the damaged parts of the shoulder are removed and replaced with artificial components, prosthesis. A plastic cup is fitted into the shoulder socket and a metal ball is attached to the top of the upper arm bone. The prosthesis mimics the normal anatomy of the shoulder, using the rotator cuff muscles to function properly.
In a reverse total shoulder replacement, the socket and metal ball are switched. The metal ball is fixed to the socket and the plastic cup is fixed to the top of the upper arm bone. For patients with large rotator cuff tears or shoulder arthritis (arthropathy) reverse total shoulder replacement is a better option because the rotator cuff muscles no longer function. The reverse total shoulder replacement relies on the deltoid muscle, instead of the rotator cuff, to position and power the arm.
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. Many times, it takes from three to six months for the shoulder to heal. Regaining full strength and range of motion can take up to a year.
What to expect directly after surgery:
Directly following shoulder replacement surgery, many patients are unable to move the wrist and /or fingers of the arm that was operated on. This is absolutely normal and occurs due to the anesthetic block used during surgery. The block usually wears off within 24 hours, returning function to the patient’s wrist and/or fingers.
Patients should expect to have bruising and inflammation in their arm, and hand. This is a natural result caused by the bruising in the shoulder.
The patient’s arm will be in a sling for the first two to four weeks.
Some patients remain in the hospital for a night or two; however, many physicians at Aptiva Health are performing more total shoulder replacement surgeries on an outpatient basis.
The day after surgery patients can begin eating solid food.
Following surgery, patients will need a driver as they are not permitted to drive for four to six weeks. A day or so following the surgery, your doctor or nurse will give you oral drugs to ease the discomfort. Post-operative physical therapy is started right away, usually on the day of surgery.
During the first week after surgery:
Patients receive small exercises to perform to keep the blood circulating. These exercises need to be performed frequently as they contribute to the patient’s ability to increase their range of motion and regain strength.
The surgical wound should remain dry until it is completely healed.
Patients will need assistance with common household tasks.
Two to four weeks following surgery:
The operating surgeon removes the patient’s sutures two weeks after shoulder surgery; however, for protection and support, the patient’s arm remains in the sling.
Patients must avoid lifting anything that weighs more than a few pounds. Individuals with small children and/or pets will need assistance caring for them.
During this period, formal physical therapy begins.
As the patient builds strength, he or she will regain independence.
Six weeks following surgery:
Once the patient regains full shoulder movement, he or she will probably be able to resume driving. The operating surgeon may also permit the patient to return to work, depending on the physical activity necessary to perform his or her job. Patients will also begin strengthening exercises at this time.
In general, most people are able to resume gentle daily living activities within this six week period.
Three months following surgery:
The patient’s range of motion increases and pain begins to diminish. Therefore, he or she can usually return to normal daily activity and a moderate workout routine.
However, contact sports still need to be avoided.
Six months following surgery:
Typically by this point, patients are ready to graduate the post-operative physical therapy program and medical follow-up plan.
At Aptiva Health, the majority of patients are pain-free at this stage; however, some patients do experience aches related to the weather.
It will take about six months before you can expect to return to more vigorous activities, such as golfing or swimming.
For more information about your recovery following shoulder replacement surgery, take a look at our post-operative protocols.