Shoulder Replacement Surgery

Doctors recommend joint replacement surgery when shoulder pain and loss of function become severe and when medicines and other treatments no longer relieve pain. Your doctor will use X-rays to look at the bones and cartilage in your shoulder to see whether they are damaged and to make sure that the pain isn't coming from somewhere else.

Shoulder replacement may not be recommended for people who:

• Have poor general health and may not tolerate anesthesia and surgery well.
• Have an active infection or are at risk for infection.
• Have osteoporosis (significant thinning of the bones).
• Have severe weakness of or damage to the muscles around the shoulder.

Some doctors will recommend other types of surgery if possible for younger people and especially for those who do strenuous work. A younger or more active person is more likely than an older or less active person to have an artificial shoulder joint wear out.

Most people have much less pain after shoulder replacement surgery and are able to do many of their daily activities more easily.

The shoulder will not move as far as it did before you started having shoulder problems. But the surgery will allow you to do more of your normal activities without pain.

After surgery, you may be allowed to resume activities such as golfing, riding a bike, swimming, walking for exercise, dancing, or cross-country skiing (if you did these activities before).

Your doctor may discourage you from doing things that put a lot of stress on the joint.

The younger you are when you have the surgery, and the more stress you put on the joint, the more likely it is that you will eventually need a second surgery to replace the first artificial joint. Over time, the components wear down or may loosen and need to be replaced.

Your artificial joint should last longer if you do not do hard physical work or play sports that stress the joint. Shoulder replacements usually last for about 10 to 20 years.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure to have extra help at home. This is most important if you live alone or care for another person.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Shoulder replacement surgery replaces the worn parts of your shoulder joint. When you leave the hospital, your arm will be in a sling. It will be helpful if there is someone to help you at home for the next few weeks or until you have more energy and can move around better.

You will go home with a bandage and stitches, staples, skin glue, or tape strips. You can remove the bandage when your doctor tells you to. If you have staples, your doctor will remove them in 10 to 21 days. If you have stitches that are not the type that dissolve, your doctor will remove them in 10 to 14 days. Glue or tape strips will fall off on their own over time. You may still have some mild pain, and the area may be swollen for several months after surgery. Your doctor will give you medicine for the pain.

A physical therapist will show you what exercises to do at home.

You will continue the rehabilitation program (rehab) you started in the hospital. The better you do with your rehab exercises, the sooner you will get your strength and movement back. Depending on your job, you may be able to go back to work as early as 2 to 3 weeks after surgery, as long as you avoid certain arm movements, such as lifting. It takes at least 6 months to return to full activity.

In the future, make sure to let all health professionals know about your artificial shoulder so they will know how to care for you.