Shoulder Replacement

What is a shoulder replacement?

A shoulder replacement is a procedure that tries to eliminate the source of pain and dysfunction by replacing damaged parts of the shoulder joint with artificial components called prostheses. The most common reasons for a shoulder replacement surgery are osteoarthritis, rotator cuff tear arthropathy, avascular necrosis or rheumatoid arthritis. The procedure is meant to relieve your pain, improve your strength, increase your range of motion and enable you to use your shoulder and arm.

How does your shoulder work?

Similar to the hip joint, your shoulder is a large ball and socket joint. It can rotate through a greater range of motion than any other joint in your body. The shoulder joint is made up of bones, tendons, muscles and ligaments which hold the shoulder in place and allows for its movement. Bones of the shoulder joint include the Clavicle (collar bone), Scapula (large flat triangular bone called shoulder blade) and Humerus (upper arm bone).

Why is a shoulder replacement done?

Shoulder replacement surgery is an option given to patients who suffer from joint dysfunction. This is usually the result of osteoarthritis, rotator cuff tear arthropathy, avascular necrosis, or rheumatoid arthritis, or (rarely) for those who have sustained a severe fracture from a trauma or fall. Generally, all other modes of treatment are considered first, such as physical therapy and medications.

You may be a candidate for shoulder replacement surgery if you have the following symptoms:

Your shoulder pain is so severe that you struggle with everyday activities such as washing, getting dressed and reaching into a cabinet.
You have loss of motion in your shoulder.
You have weakness in your shoulder.
You have pain that’s so bad that it prevents you from getting a good night’s sleep.
You’ve tried anti-inflammatory medications, cortisone injections and physical therapy with no relief.
You have prior arthroscopic surgery, rotator cuff or fracture repair that failed to relieve your symptoms.
What are the types of shoulder replacements?
Your surgeon will have a conversation with you regarding what type of shoulder replacement you may need.

We try to do our best to help you and provide with a high-quality services.

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Unless there is an emergency, your surgery will be scheduled in advance. Knowing the date of your operation, you will have enough time to prepare and plan for any special help you might need following discharge from the hospital. It is important to have a partner to assist you with your home exercises following discharge. Your partner should accompany you to physical therapy at least once or twice during your hospital stay. Shoulder replacement can be done as an outpatient procedure but on average, you will be staying one night in the hospital after surgery to make sure your pain is controlled and you are medically stable before leaving the hospital.

A series of pre-operative tests will be scheduled one to two weeks before surgery. They usually include: some blood tests, an electrocardiogram (EKG) that evaluates the electrical activity of your heart and a visit with a healthcare provider to make sure you are medically cleared to undergo surgery. Some medications may be discontinued because they will complicate surgery and other medications you may need to continue. You should discontinue use of any anti-inflammatory medication, including aspirin, one week before surgery unless instructed otherwise. You will be given instructions regarding your daily medications in this visit.

Most patients spend the night before surgery either at home or in a hotel nearby. They are then admitted to the hospital the next morning. You will be informed via a phone call the day before about the exact time and location to go on the day of the surgery. You may not eat or drink anything after midnight the day before your surgery.

Your physician and the anesthesiologist will discuss the type of anesthetic that is most appropriate. The most frequent form is general anesthesia by giving you medications through your IV which will keep you relaxed, comfortable and sedated. You will also be given a choice to supplement your anesthesia with a regional or block anesthetic to minimize your postoperative pain.

After surgery, most patients are able to eat a regular dinner and walk to the bathroom. Regional anesthesia offers prolonged pain relief after the operation. A family member may remain with you until the time of your surgery (depending on hospital visitation rules). Any nail polish should be removed prior to admission. You will be asked to remove all jewelry, glasses, dentures, wigs and contact lenses. No rings may be worn on either hand and any articles of value should be left home or given to your family members.

The nurses will prepare you for surgery by taking your blood pressure, pulse, temperature and administering pre-operative medications. These medications may cause drowsiness and a dry mouth. An IV or intravenous line for fluid, medication and antibiotics will then be inserted in your arm before going to the operating room.

You will be transported to surgery on a cart. Different hospital staff will be asking your name, verifying your identification bracelet and asking you which shoulder will be operated on, right or left.

Your family may wait in the designated area, where they can check in with the receptionist. As soon as your surgery is over, your surgeon will call the waiting area and ask to speak with your family. If surgery gets prolonged for any reason, your surgeon will usually give periodical updates to your family members and keep them informed about the progress.

In the operating room, you will meet nurses, physicians, technicians and anesthesiologists. The operating room will be bright and very cool. Blankets are available to keep you warm. Because of the number of people working, the room will seem very busy and somewhat noisy. You will then be moved to the operating table and made comfortable. Sterile surgical draping will be hung to shield and protect the surgical site. The anesthesiologist will remain by your head, monitoring your condition throughout the surgery.

After surgery, you will be transported to the Post Anesthesia Recover Unit (PACU), where you will be cared for by skilled nurses and members of the anesthesiology team. They will monitor your vital signs (blood pressure, pulse and breathing) frequently while you are recovering from the effects of anesthesia. When you wake up, you will have a dressing on your shoulder. An x-ray of your shoulder will be done during your stay in the recovery room.

The minimum stay in a PACU is at least one hour. The length of your stay depends on many factors including the effects of anesthesia. Your physicians and nurses will evaluate your condition and determine the best time for you to be released to a hospital room. Your family will not be permitted in the PACU, but may visit when you are assigned to a hospital room.

After being transported to your room and assisted into your bed, your nurse will evaluate your condition — checking your vital signs, shoulder dressing and the movement and sensation of your hand. Your arm may be placed in a sling for the first 24 hours following surgery.

Because shoulder surgery is painful, pain control is very important. Your regional nerve block should mask most of the pain but at times, the block may not work 100% and you may need to take oral pain medication to remain comfortable.

During your hospitalization, you are encouraged to get out of bed and move around. Bring loose-fitting clothing with you, as this will make dressing easier. You’ll be able to shower after 48 hours.

The physical therapist will help you learn specific restrictions and exercises and how to continue them at home. You will also be given written instructions upon your discharge. These exercises are fairly simple and usually require only a short amount of time.

A successful outcome to your total shoulder joint replacement depends heavily on the meticulous performance of your exercises. Through this structured exercise program, your muscles will be methodically and progressively stretched and strengthened over one year’s time. The desired effect is the optimal function of your new total shoulder replacement. Most patients, do not require physical therapy but, in certain situations, formal outpatient physical therapy after hospital discharge may be required. Your surgeon will discuss this with you in your follow up office visits based on your progress with the self-directed exercises.

An occupational therapist will visit you at least once in the hospital before you are discharged. Your therapist will provide instruction and assistive devices to help you maintain your independence and protect your new shoulder from injury.

Shoulder Replacement

What is a shoulder replacement?

How does your shoulder work?

Why is a shoulder replacement done?

We try to do our best to help you and provide with a high-quality services.

Have Some Questions?

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