Total Shoulder Replacement

The shoulder joint is the third most frequently replaced joint after the hip and knee, with roughly 50,000 procedures being performed in the United States between 2005 and 2006.

Lack of range of motion and pain are the main reasons patients consider this operative treatment. Whether your pain and limited range of motion is a result of osteoarthritis, a rotator cuff tear or a fracture, it can be very debilitating and can affect normal day-to-day activities.

The first step to returning to an active lifestyle is to make an appointment with your orthopaedic surgeon. After a thorough examination, your surgeon will make a recommendation regarding surgery. Generally speaking, you are a candidate if you experience shoulder joint pain that is severe enough to prevent you from carrying out normal daily activities and your pain is not responsive to non-surgical treatments. Chronic shoulder problems can prevent you from enjoying everyday activities, but thanks to today’s advanced technology, you no longer have to live with pain.

Complications/Risks

Joint replacement surgery is a major operation. As with any major operation, there are possible complications. Some of these are related to anesthesia, while others are associated with the joint surgery itself. Every possible effort is made by the medical team to prevent complications, but this cannot be accomplished without your participation. Therefore, it is important that patients know about the following, which include but are not limited to, infection, blood clots, implant breakage, malalignment, stiffness, dislocation and nerve damage.

Any of these can require additional surgery. Although implant surgery is successful in most cases, some patients still experience stiffness and pain. No implant will last forever and factors such as a patient’s age and activity level can affect longevity. Your surgeon will discuss these and other relevant risks with you.

There are many things that your surgeon will do to minimize the potential for complications. Your surgeon may ask you to see your family physician before surgery to obtain tests to better understand your medical condition.

After Surgery

After surgery you will receive pain medication and begin physical therapy. Depending on the procedure, you may be encouraged to use your arm soon after the surgery. You also may be asked to begin shoulder exercises to regain motion and strength. These exercises can be performed at home or on an outpatient-basis with supervised therapy. The specifics of your rehabilitation will be determined by your surgeon based on your condition.

Most patients are ready to go home between one to two days after surgery and may be asked to do shoulder exercises at home or with supervised therapy. You will be shown a variety of exercises designed to regain mobility and strength in your shoulder. It is important to follow the physical therapy protocol provided by your surgeon in order to facilitate the recovery process.

Recovery

Exercise is crucial for proper rehabilitation. Therapy may begin the same day as your surgery and may continue up to four to six months post-op. Proper rehabilitation and willingness to follow all of your surgeon’s recommendations will contribute to a more successful recovery after surgery. Most patients are able to resume waist-level activities (writing) and possibly driving three to four weeks post-op depending on your surgeon and your condition. Activities such as golf, tennis and swimming can usually be resumed, but only after a thorough evaluation by your surgeon. Recovery time will vary for each patient.

High-impact activities or contact sports are typically not recommended. These types of activities place an extreme amount of pressure on the joints, which could lead to complications. Your surgeon will discuss this with you.

Your surgeon will likely continue to evaluate your progress during the life of the prosthesis on a yearly basis. These evaluations may or may not require X-rays. It is important to see your surgeon if you notice any unusual changes regarding your new joint.