Shoulder replacement is an operation to replace your shoulder joint with an artificial joint. You can have a complete or partial shoulder replacement. You may have this surgery for shoulder joint damage, or wear and tear. This is usually from arthritis or an injury.
Your shoulder is a ball-and-socket joint. The ball at the top of your upper arm moves smoothly in the socket of your shoulder blade on a lining of cartilage (a type of strong tissue). The cartilage prevents your bones from rubbing together. Damage to the cartilage from an injury or arthritis can make your joint painful and stiff.
A new shoulder joint can help to improve your shoulder movement and reduce pain. Artificial shoulder parts are usually made of metal or plastic or a combination of the two.
The average age for people having a shoulder replacement is around 70. But many people are older than this when they have the surgery. An artificial shoulder joint will usually last for at least 10 years, often for much longer.
There are four main types of shoulder replacement procedure.
This is the second most common type of shoulder replacement procedure. If you have this type of operation, your surgeon will replace the ball at the top of your upper arm with a new metal ball. They’ll also replace the socket in your shoulder blade with a new plastic socket. As with the reverse replacement, the new ball and socket are fixed in place with bone cement.
In a partial shoulder replacement, the surgeon only replaces the ball at the top of your arm. The new metal ball will then move within the socket you already have.
This means replacing only the worn surfaces of the shoulder joint. This operation can also be partial or total. In partial resurfacing, the surgeon removes the damaged surface of the ball and places a cap over it. In total resurfacing, the surgeon removes the surface of the ball and the socket. They replace these with a cap over the ball and a plastic socket.
A repeat shoulder replacement operation is known as a revision. You may need this because your implant has become loose or worn out. Overall, only one in 10 people needs a revision operation within 10 years of their operation. Even after 18 years, fewer than two in 10 patients overall need further surgery. But the risk is higher in men under 60.
Revision surgery can be more complicated than your first operation. Your surgeon has to remove your artificial joint before they can put in a new one. Also, removing more of the bone of your upper arm in a second operation can make it more likely to fracture. It usually takes you a little longer to recover from a repeat shoulder replacement than from the first operation.
Talk to your surgeon if you’d like more information about revision surgery.
Most hospitals invite you for a pre-admission visit a week or so before your surgery. In the clinic, they’ll check that you’re fit for your operation and anaesthetic. This visit gives you a chance to ask any questions you have about your admission. Your surgeon will tell you how to prepare for your procedure. If you smoke, they’ll ask you to stop. Smoking slows wound healing and increases your risk of a chest or wound infection. So, it can delay your recovery.
Before you go into hospital, think about how you’re going to get to and from hospital and manage at home afterwards. Make sure someone can take you to the hospital and bring you home after your operation. Plan to be away from home for between two and five days. Once you go home, you might want someone to stay with you to help out for a while.
If you're having a general anaesthetic, you can’t eat or drink for about six hours beforehand. Your surgeon or anaesthetist will tell you exactly how long. It’s important to follow their advice.
Your surgeon will talk over what will happen before, during and after your operation. They’ll tell you how painful it is likely to be and about the painkillers you’ll have. Once you understand the procedure, and if you agree to have it, your doctor will ask you to sign a consent form.
These are part of the range of treatments for osteoarthritis and rheumatoid arthritis.
If your surgeon thinks surgery is the best option for you, they’ll explain why.
Shoulder replacement is carried out by an orthopaedic surgeon. This is a doctor who specialises in bone surgery. They will have specialist training in the procedure.
You have a shoulder replacement with either a general or regional anaesthetic . A general anaesthetic means you’ll be asleep during the operation. A regional anaesthetic completely blocks pain from your shoulder. But you’ll be awake throughout the operation.
You may have both types of anaesthesia. Regional anaesthetic helps to ease pain after surgery. Your anaesthetist will talk to you about which type of anaesthesia is best for you. If you’re feeling very anxious, you might have a sedative as well as a regional anaesthetic.
Your surgeon will make a cut (incision) to reach your shoulder joint. This is usually down the front but may be at the side of your shoulder. At the end of the operation, your surgeon will close the cut with stitches or clips. The wound is then covered with a dressing.
You usually need to stay in hospital for two to five days after your operation.
If you have a regional anaesthetic, it may take several hours before you get feeling back in your shoulder. You’ll have pain relief to help with any discomfort. You may have injections, tablets, or patient-controlled analgesia (PCA) through a drip. With PCA, you have a button to press when you need more painkillers. This means you can control the amount of pain relief you receive. Tell your nurse if you’re in pain. Having good pain control will help you to recover.
Your surgeon may want you to wear elastic stockings and have injections of anti-clotting medication for a few days after your surgery. This is very common after many types of surgery and helps to prevent blood clots (deep vein thrombosis).
You may have fine tubes running out from your wound. These drain fluid into a bag and are usually removed after a day or two.
A physiotherapist will visit you after your operation. They’ll guide you through exercises and ways to move your shoulder to help you recover. You’ll probably start these the day after your operation. This helps to prevent stiffness and will help your shoulder to heal. It’s very important that you follow the advice you’re given about how to move your shoulder.
You may have an X-ray taken of your new joint while you’re in hospital.
Your nurse should give you some advice about caring for your healing wounds before you go home. They may also give you a date for a follow-up appointment. Having a general anaesthetic can affect your co-ordination and make it difficult to think clearly. You shouldn’t drink alcohol or operate machinery for 24 hours after your anaesthetic. You should also wait to sign important documents until you’ve recovered. You won’t be able to drive for a while after your shoulder operation.
It usually takes at least three to six months to make a full recovery from a shoulder replacement.
You’ll go home from hospital with a sling to support your arm and shoulder. For up to four weeks after the operation, you will need to wear it all the time, including at night. Your surgeon or physiotherapist will give you advice about when to wear your sling before you leave the hospital.
Your physio will give you an exercise plan to help your recovery. These will help to get your shoulder joint moving. And they’ll strengthen the muscles around your shoulder. It’s important to continue to do the exercises for as long as your physiotherapist recommends. These will help your shoulder to heal and may help you to recover more quickly. Your physio will also tell you about some movements you shouldn’t do, including putting your arm behind your back.
You should also take care not to use your arm to push yourself up out of bed or a chair. Within a few weeks, you should be able to do simple everyday tasks like washing and dressing. Your surgeon may tell you not to lift anything heavier than a cup of tea for six weeks after your operation. Don’t do any heavy lifting or play any contact sports for at least six months.
Ask your surgeon for advice about returning to work and other activities. How quickly you can drive again will depend on how well you are recovering. You must be able to safely control your vehicle and perform an emergency stop. Always follow your surgeon’s advice. You should also contact your motor insurer before driving.
You will usually have painkillers to take home with you when you leave hospital. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist. Some people need painkillers for longer than others. If you have severe pain or it doesn’t get better, contact your surgeon for advice.
Side-effects are unwanted effects you may have from any medical treatment. After shoulder replacement surgery you may have:
These side-effects are usually temporary. They should gradually settle over four to six weeks.
Complications are when problems occur during or after the operation. These complications don’t happen very often, but it’s good to be aware of them.
With any operation there is a risk of a reaction to the anaesthetic or excessive bleeding. You may also develop a blood clot. If this happens, it usually develops in a vein in the leg (deep vein thrombosis ).
Complications that may occur around the time of shoulder replacement surgery include the following.
In some cases, you may have to have a further operation on your shoulder if you develop complications. If you want to know more about possible complications, ask your surgeon.
It’s natural to have pain after an operation. But everyone is different so it’s not possible to say exactly how you’ll feel. You’ll be given painkillers straight after youroperation. You’ll usually have some to take home too. There’s more about pain after shoulder replacement surgery in our aftercare and recovery sections.
It usually takes three to six months to recover from this type of shoulder surgery. But you might find your shoulder function continues to get better for up to a year. There is more about recovery in the section ‘Recovering from shoulder replacement'.
Shoulder replacement is generally very successful, with implants lasting as long as 20 years. As with any joint replacement, the implant can loosen or wear out over time. But overall, only one in 10 people needs revision surgery within 10 years of their operation. For more information see the section ‘Types of shoulder replacement’.
www.versusarthritis.org
The information and/or article is solely the contribution of Bupa, (hereinafter referred to as “Bupa UK”) a United Kingdom (UK) based healthcare services expert and is based on their experiences and medical practices prevalent in UK. All the efforts to ensure accuracy and relevance of the content is undertaken by Bupa UK. The content of the article should not be construed as a statement of law or used for any legal purpsoe or otherwise. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (hereinafter referred to as “the Company”) hereby expressly disown and repudiated any claims (including but not limited to any third party claims or liability, of any nature, whatsoever) in relation to the accuracy, completeness, usefulness and real-time of any information and contents available in this article, and against any intended purposes (of any kind whatsoever) by use thereof, by the user/s (whether used by user/s directly or indirectly). Users are advised to obtain appropriate professional advice and/or medical opinion, before acting on the information provided, from time to time, in the article(s).
Please click on Agree button to be Redirected to BANCA Site.
Else click on close icon.