Shoulder replacement surgery replaces a worn, painful shoulder joint with a new, functional joint made from metal and plastic.
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The surgery relieves debilitating shoulder joint pain caused by a shoulder condition or injury that interferes with daily life.
Total shoulder replacement is a surgery done to treat different shoulder conditions and injuries, such as: Severe shoulder fractures or other serious shoulder injuriesOsteoarthritisRheumatoid arthritisAvascular necrosisRotator cuff injury
resulting in joint arthritis
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: Chronic shoulder pain and stiffnessShoulder instabilityInfectionNerve damageLoose shoulder joint
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinking
Chronic disease such as
Before surgery, you may meet with your doctor for a physical exam, medical history, and tests. You may have blood tests.
Imaging studies that help evaluate the shoulder joint and surrounding structures include: X-raysCT scanMRI scan
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 2 weeks before the procedure.
You may be given either: General anesthesia
—you will be asleep through the surgery
Regional anesthesia—used to block pain in the upper body, but you will not be asleep
The doctor will make a cut through your skin near your shoulder. The large muscles around the shoulder will be pulled back. Another incision will be made in the rotator cuff. The rotator cuff is made up of tendons that cover and support the shoulder joint. Pulling back the muscles and tendons will allow the doctor to have a clear view of the shoulder joint.
The doctor will then remove the shoulder joint and replace it with an implant that looks very similar. It includes a ball, socket, and stem parts.
After inserting the implant, the doctor will close the rotator cuff, muscles, and skin with stitches. A drain may also be inserted to remove fluids that may build up in the shoulder after surgery.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
This surgery is done in a hospital. The usual length of stay is 2-3 days. If you have any problems, you may need to stay longer.
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include: Pain medicationsAntibiotics to prevent infectionMedication to prevent blood clotsX-rays to evaluate the new shoulder joint
You may start physical therapy as early as the day after your surgery. A physical therapist will work with you to help you regain your range of motion and strength in your shoulder. You will also continue physical therapy after you leave the hospital.
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions
You will wear an arm sling for the first several weeks after surgery. The sling will help support your shoulder as it heals. You should be able to do simple tasks, like feeding yourself and dressing, within 2 weeks after surgery. In the meantime, family members or friends may help you with daily activities.
The staff will teach you how to care for any dressings or bandages. This will help prevent wound infection.
Antibiotics may be needed before certain dental procedures or surgeries now that you have an artificial joint. This will prevent possible infections from entering the bloodstream. Make sure to let the dentist or doctor know that you have an artificial joint.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor: Shoulder stiffness, pain, or instabilityProblems at the incision site, such as bleeding or drainageSigns of an infections such as fevers, chills, redness, or warmthNumbness or tingling in your shoulder, arm, or fingers
If you think you have an emergency, call for medical help right away.
Arthroplasty. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/arthroplasty_92,P07677. Accessed November 19, 2013.
Degenerative joint disease of the glenohumeral joint. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 7, 2013. Accessed November 19, 2013.
Joint replacement—shoulder. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/health/treatments_and_procedures/hic_Total_Shoulder_Joint_Replacement. Updated July 21, 2009. Accessed November 19, 2013.
Shoulder joint replacement. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00094. Updated December 2011. Accessed November 19, 2013.
Shoulder replacement surgery: diagnosis, treatment, and recovery. Hospital for Special Surgery website. Available at:
http://www.hss.org/conditions_Shoulder-Replacement-Surgery-Diagnosis-Treatment-Recovery.asp. Updated July 1, 2013. Accessed November 19, 2013.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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