Shoulder replacement surgery replaces the worn parts of your shoulder joint with artificial parts. It is a complex procedure performed to relieve pain and improve mobility. If you have severe arthritis or a fracture in your shoulder joint, you may need a shoulder replacement.
The shoulder is a “ball and socket” joint, with the ball-shaped head of the upper arm bone (humerus) fitting into a socket called the glenoid. The ball is the upper part of the arm bone (humerus) and is called the humeral head. The socket is smaller and is part of the shoulder blade (scapula). A rotator cuff is a group of four muscles and tendons that helps with lifting and rotating the arm. It also helps to stabilize the shoulder and facilitate shoulder movement.
The ball is held in the socket by ligaments and by the rotator cuff tendons.
Shoulder Replacement Procedure
In shoulder replacement, a plastic cup is fitted into the shoulder socket (glenoid), and a metal ball is attached to the top of the upper arm bone (humerus). The ball is replaced with this metal ball attached to a stem. The stem is inserted down the shaft of the humerus, and sometimes cement is used to keep the stem in place. At times, the socket is replaced with a plastic piece that is usually fixed to a groove in the socket with cement. Whether a socket is used or not depends upon how bad the arthritis is in the shoulder and whether the rotator cuff tendons are intact.
Shoulder Replacement FAQs
Shoulder replacement surgery is major surgery, so you can expect to be off from work for up to 6 weeks.
Generally, shoulder replacement surgery takes about 3 hours. This includes anesthesia time.
General anesthesia or local anesthesia may be used for shoulder replacement surgery.
Since shoulder surgery is a major operation, you can expect to experience pain during your recovery. To ease your discomfort, you may be given pain medications by injection right after your procedure, and then oral drugs a day or so following the surgery to ease the discomfort.
You may need shoulder replacement if you are experiencing severe pain associated with arthritis or when the shoulder is severely fractured or broken. Other signs that may indicate you would benefit from shoulder replacement include:
- Aching in the joints followed by periods of relative relief
- Pain after extensive use
- Loss of motion
- Joint stiffness after periods of inactivity or rest
- Pain that increases in humid weather
Shoulder replacement surgery is usually performed in a hospital. You can expect to stay in the hospital 2 to 3 days before being released.
Shoulder replacement surgery cannot be done at an outpatient facility for Medicare patients, as Medicare deems it an inpatient procedure.
For other patients, shoulder replacement surgery in an outpatient facility may be considered if the patient is in overall good health, does not have severe bone loss or significant stiffness, is not obese, and is younger than 65 years old. Before even considering this surgery on an outpatient basis, patients should talk to their insurance providers to see if they will cover this procedure on an outpatient basis.
For the first day or so after surgery, patients use a morphine pump to control their own pain medicine then they switch over to oral pain medication. Antibiotics are also given the first day to prevent infection.
After surgery, your arm will be in a brace and it can easily be removed to do physical therapy exercises.
Recovery time from shoulder replacement surgery may take up to 6 weeks. During this recovery period you can expect the following:
- You will have follow-up visits with your doctor every few weeks for several months.
- Stitches are removed within 1 week after surgery.
- You will not be able to drive for 4 to 6 weeks after surgery.
You can also expect to start physical therapy the day after surgery. Therapy will start with moving the fingers, wrist, and elbow, and then progressing to some movement of the shoulder. Your physical therapist will show you what exercises you can do at home. Exercises should be done daily to avoid stiffness.
Within 7 to 10 days after surgery, you will need to go to an outpatient physical therapy facility for further treatment. Therapy may take several weeks to ensure that you regain normal motion and strength in your shoulder.
You may shower after 48 hours as long as the wound is covered with Saran Wrap and securely tied to keep it dry. Avoid taking baths for up to 3 weeks.
After surgery, men should wear loose-fitting sleeveless undershirts and loose button-down shirts. Women should avoid wearing traditional bras for up to 2 weeks, and wear T-back or racerback bras instead.
After shoulder replacement surgery, you will need to sleep at an incline for 4 to 6 weeks with your sling on. This means you should avoid sleeping on your side or on your back.
Some patients sleep on a recliner or they use pillows or a 45-degree wedge (available online through medical supply stores) to prop themselves up into an upright position on the couch or in a bed.
Overall, the success rate for pain relief for shoulder replacement surgery is very good, and most patients report they are very satisfied with the results of their surgery.
A good outcome from surgery often depends on patients following their doctor’s post-op instructions starting with scheduling and showing up for your follow-up appointments and
- Wearing your shoulder immobilizer or sling
- Participating in physical therapy
- Practicing physical therapy exercises at home
- Taking pain medication as directed
- Avoiding certain shoulder positions and arm movements
As with any surgery, there are some associated risks and complications. For shoulder replacement surgery, the possible complications may include:
- Nerve or artery damage
- Implant dislocation
- Loosening of implants from bone over time