A shoulder replacement surgery is a complex procedure that can alleviate joint pain, and preserve shoulder function. In this kind of surgery, the damaged portions of the shoulder are removed and replaced with artificial implants.
What is the Purpose of a Shoulder Replacement?
Your doctor at Comprehensive Medical Care may recommend a shoulder replacement if you experience shoulder pain that does not respond to non-surgical treatments, such as rest, physical therapy, medications, or anti-inflammatory injections.
Most shoulder replacements are recommended due to pain caused by arthritis, or when the shoulder is severely fractured or broken. There are two main types of arthritis that affect the shoulder.
Osteoarthritis, also known as degenerative joint disease, is the most common kind of arthritis that occurs as a result of natural wear and tear on the cartilage inside the joint. Osteoarthritis is most often experienced in adults over 50, and it is more common in the knees, hips, and fingers than the shoulders. However, osteoarthritis in the shoulder is very common in competitive athletes, especially tennis players and volleyball players, who are continually putting pressure on their shoulder. In some cases, a severe, acute injury can contribute to long term damage.
Inflammatory arthritis is an overarching term used to describe joint inflammation caused by several chronic, autoimmune diseases that are a result of an overactive immune system. The primary two kinds of diseases that detriment the shoulder are:
- Rheumatoid arthritis
- Ankylosing spondylitis
These inflammatory forms of arthritis are significantly less common than osteoarthritis, which eventually affects a large portion of people in their later years.
Shoulder Replacement Benefits
On average, 53,000 people get shoulder surgeries every year in the United States. Out of all these shoulder replacements, only about 5% of cases of patients experience complications post-surgery. Besides being a highly successful surgery, there are many other benefits to having a shoulder replacement procedure, such as:
- Revives mobility
- Alleviates pain
- Replenishes strength
- Restores normal function
A majority of patients are able to return to the activities they love, such as golf, volleyball, swimming, yoga, or any other physical activity that they previously avoided due to shoulder pain.
Shoulder Replacement Risks
Like any surgery, there are certain risks associated with total shoulder replacements. All different surgeries can result in:
- Excessive bleeding
- Infection at incision site
- Allergic reaction to medications administered during the surgery
- Anesthesia-induced breathing difficulties
Though rare, only happening in less than 5% of cases, the risks specific to a shoulder replacement include:
Instability occurs in the shoulder if the prosthesis wears down, causing the replacement implants to potentially dislocate. Excessive wear, loosening, or dislocation may require additional surgery. Fortunately as prosthesis designs and surgical techniques continue to advance, these complications occur less and less frequently.
In a shoulder replacement surgery, infection may occur at the incision site or deep around the artificial implants. Infection can occur in the hospital, or it may even occur years later. Any infection in your body can potentially spread to your joint replacement.
Nerves in the vicinity of the joint replacement can potentially be damaged during the surgery. Though very uncommon, these nerve injuries usually improve and can make a full recovery.
Stiffness typically occurs as a result of incomplete rehabilitation, and finishing physical therapy is an effective way to restore full shoulder motion and strength.
What to Expect From Your Shoulder Replacement
A traditional shoulder replacement surgery usually takes about two to three hours, and is composed of the following steps:
- The surgeon separates your deltoid and pectoral muscles so he or she can access the shoulder in a prominently nerve-free area in order to limit nerve damage.
- The muscles are removed from your rotator cuff so the surgeon can extract the arthritic parts of the ball and socket joint.
- The artificial implants are inserted. The metal ball is attached to the plastic stem, which extends inside the patient’s humerus, replacing the head of the humerus bone. The plastic socket replaces the glenoid, which is the socket joint of the shoulder.
- The muscles on the rotator cuff are replaced and stitched back on.
- The external incision is cleaned and stitched, and a bandage is applied over the wound.
During this procedure, you will most likely receive a general anesthesia to put you to sleep, and a regional anesthetic. The regional anesthetic is also known as an interscalene block, and it is used to block the nerves in your arm entirely, making your arm completely numb for 24 to 48 hours following surgery.
What to Expect From Your Shoulder Replacement Recovery
After your shoulder replacement surgery, you will most likely stay in the hospital for two to three days. The duration of each hospital stay will vary with each individual, depending on how quickly he or she progresses. After your hospital stay, it is very important to carefully follow your doctor’s instructions when you get home.
After your shoulder replacement, it is perfectly natural to feel pain as a part of the healing process. Medications, like opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and other local anesthetics will often be prescribed for short-term pain relief post-surgery. Your doctor may also recommend taking over-the-counter drugs, like aspirin or ibuprofen to lessen the risk of blood clots.
After surgery, your shoulders will have staples along your skin, or sutures beneath your skin. The staples will be removed several weeks post-surgery, but the sutures will not require removal. It is very important to avoid soaking the wound in water until it has been thoroughly sealed and dried. Therefore, make sure to listen to your surgeon’s recommendations on when to shower and bathe, and how often to change the bandages.
One of the most critical steps in the recovery process is to complete your shoulder rehabilitation exercises. Prescribed either by your surgeon or a physical therapist, rehabilitation will be able to restore mobility and strength to the muscles in your arm and shoulder so that you may return to normal function.
Physical therapy will begin the day after surgery, and starts with moving exercises of the fingers, wrist, and elbow. After you are discharged from the hospital, the physical therapist will show you exercises to complete at home or in a fitness facility.