Shoulder Replacement Surgery

________________________________________________________________________

KEY POINTS

• Shoulder replacement surgery is a procedure done to remove a painful, broken, or arthritic shoulder joint and replace it with an artificial shoulder joint.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

________________________________________________________________________

What is a total shoulder replacement?

Shoulder replacement surgery is a procedure done to remove a painful, broken, or arthritic shoulder joint and replace it with an artificial shoulder joint.

Your shoulder is a ball-and-socket joint where the top of your arm bone meets the cup-shaped socket of your shoulder blade.

When is it used?

Conditions such as arthritis or damage caused by a fracture, dislocation, or injury to the tissues around the joint may cause shoulder problems. This surgery may be done when your shoulder joint is very painful or is not working well and other treatments have not helped.

Shoulder replacement should relieve the problems of a painful shoulder. After surgery you should be able to move your shoulder more easily and with less pain. It will be easier for you to do activities that use your shoulder. Most people get back to a more normal life.

This surgery may not be recommended if you have certain health problems. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Talk to your healthcare provider and to other people who have had the surgery. Knowing what to expect can help lessen anxiety about the operation.
• You may meet with a physical therapist before surgery to learn exercises that will help you after surgery. If you can, increase your arm motions and general exercise before surgery. The more fit you are, the easier time it will be to recover from the surgery. Getting yourself into an exercise habit helps you continue good exercise habits after surgery.
• Because you may need blood transfusions during the operation or during recovery, you may want to donate some of your own blood before the procedure. Ask your healthcare provider about this.
• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It’s best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

You will be given medicine called general anesthesia to keep you from feeling pain. General anesthesia relaxes your muscles and puts you into a deep sleep.

Your healthcare provider will make a cut over your shoulder and remove damaged bone. A metal or plastic artificial joint will be attached to the healthy bone. Your provider will close the cut with stitches or staples. You may be given a nerve block to prevent shoulder pain after you wake up from surgery.

You may need a blood transfusion. The hospital will use either blood you have donated or blood from a donor that matches your blood.

What happens after the procedure?

You may be in the hospital for several days, depending on how fast your shoulder heals. For a day or two after surgery you may have a catheter, which is a small tube used to drain urine from your bladder. Special boots or stockings will be put on your feet or legs to help prevent blood clots. You may also need medicine to help prevent blood clots. Your healthcare provider may put your arm in a sling to keep it still. You will be encouraged to walk as soon as you can.

You will need physical therapy for weeks to months after your surgery. You will not be able to participate in some sports or activities. Ask your healthcare provider to suggest physical activities that are safe for you.

Constipation is common after joint replacement surgery. It is often caused by narcotic pain killers as well as inactivity. You may be given a stool softener and a laxative after surgery to avoid this. When you are home again, be sure to eat a high-fiber diet and drink plenty of liquids according to your provider’s recommendations.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

Let all of your healthcare providers, including your dentist, know that you have an artificial joint. If you get an infection (such as a gum, sinus, bladder, or skin infection), the infection should be treated right away. If you have a procedure (like deep cleaning for tooth and gum problems, or sinus surgery for infections), talk to your provider about taking preventive antibiotics to protect your new joint.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection, bleeding, or blood clots.
• Other parts of your body may be injured during the procedure.
• Your new shoulder joint may not move as well as a normal joint. It can be dislocated more easily.
• Your arms may not be the same length after the operation.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.