 Similar
to other joint replacement procedures, shoulder replacement
surgery is generally done to address persistent pain
that is not controlled by non-surgical therapy. Less
commonly, poor shoulder motion may also be a reason
for replacement surgery.
 The
shoulder is a ball-and-socket joint, with the
top of the arm bone (humeral head) fitting into a
socket known as the glenoid. Muscles and tendons,
such as the rotator cuff, help hold the joint in place.
Surgery involves replacing
the humeral head and the glenoid with artificial components.
The humeral head replacement is generally made from
a metal alloy, while the glenoid component is made
from polyethylene plastic. The new components may
be anchored by cement or press-fit into place so that
the bone grows in around them.
During surgery, a three- to four-inch incision is
made along the space between the arm and the collarbone.
The procedure lasts about
90 minutes, and the incision is then closed
with staples or stitches. Patients typically stay
in the hospital for one
to two nights, and full recovery usually takes
six to 12 weeks.
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| Rehabilitation
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Arthritic shoulders are stiff. One of the major goals
of total shoulder replacement surgery is to relieve
much of this stiffness. However, after surgery scar
tissue will tend to recur and limit movement unless
motion is started immediately. This early motion is
facilitated by the complete surgical release of the
tight tissues so that after surgery the patient has
only to maintain the range of motion achieved at the
operation. Later on, once the shoulder is comfortable
and flexible, strengthening exercises and additional
activities are started.
A careful, well-planned rehabilitation program is
critical to the success of a shoulder replacement.
You usually start gentle physical therapy on the first
day after the operation. You wear an arm sling during
the day for the first several weeks after surgery.
You wear the sling at night for 4 to 6 weeks. Most
patients are able to perform simple activities such
as eating, dressing and grooming within 2 weeks after
surgery. Driving a car is not allowed for 6 weeks
after surgery.
Here are some "do's and don'ts" for when
you return home:
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Don't
use the arm to push yourself up in bed or from a
chair because this requires forceful contraction
of muscles.
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Do
follow the program of home exercises prescribed
for you. You may need to do the exercises 4 to 5
times a day for a month or more.
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Don't
overdo it! If your shoulder pain was severe before
the surgery, the experience of pain-free motion
may lull you into thinking that you can do more
than is prescribed. Early overuse of the shoulder
may result in severe limitations in motion.
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Don't
lift anything heavier than a glass of water for
the first 6 weeks after surgery.
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Do
ask for assistance. Your physician may be able to
recommend an agency or facility if you do not have
home support.
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Don't
participate in contact sports or do any repetitive
heavy lifting after your shoulder replacement.
-
Do
avoid placing your arm in any extreme position,
such as straight out to the side or behind your
body for the first 6 weeks after surgery.
Many thousands of patienVts have experienced an
improved quality of life after shoulder joint replacement
surgery. They experience less pain, improved motion
and strength, and better function
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| Frequently
Asked Questions |
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| What are
the symptoms to detect Shoulder Replacement? |
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Patients
with arthritis typically describe a deep ache within
the shoulder joint. Initially, the pain feels worse
with movement and activity, and eases with rest. As
the arthritis progresses, the pain may occur even when
you rest. By the time a patient sees a physician for
the shoulder pain, he or she often has pain at night.
This pain may be severe enough to prevent a good night's
sleep. The patient's shoulder may make grinding or grating
noises when moved. Or the shoulder may catch, grab,
clunk or lock up. Over time, the patient may notice
loss of motion and/or weakness in the affected shoulder.
Simple daily activities like reaching into a cupboard,
dressing, toileting and washing the opposite armpit
may become increasingly difficult. |
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| How do I
know if I am ready for shoulder replacement surgery? |
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Patients
who have tried the usual treatments for shoulder arthritis,
but have not been able to find adequate relief, may
be a candidate for shoulder replacement surgery. Patients
considering the procedure should understand the potential
risks of surgery, and understand that the goal of joint
replacement is to alleviate pain. Patients generally
find improved motion after surgery, but these improvements
are not as consistent as the pain relief following shoulder
replacement surgery. |
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| How long
is the recovery following shoulder replacement surgery? |
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Hospital
stays vary from one to three days for most patients.
You will be sent home wearing a sling and you should
not attempt to use the arm except as specifically instructed
by your doctor.
Most physicians will begin some motion immediately following
surgery, but this may not be true in every case. Usually
within two to three months, patients are able to return
to most normal activities and place an emphasis on strengthening
the muscles around the shoulder and maintaining range
of motion. |
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| What are
the symptoms of severe arthritis of the shoulder? |
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Common
symptoms of shoulder arthritis include:
- Pain with activities
- Limited range of motion
- Stiffness of the shoulder
- Swelling of the joint
- Tenderness around the joint
- A feeling of grinding or catching within the joint
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| Can rehabilitation
be done at home? |
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In
general the exercises are best performed by the patient
at home. Occasional visits to the surgeon or therapist
may be useful to check the progress and to review the
program. |
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| When can
I return to ordinary daily activities? |
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In
general, patients are able to perform gentle activities
of daily living using the operated arm from two to six
weeks after surgery. Walking is strongly encouraged.
Driving should wait until the patient can perform the
necessary functions comfortably and confidently. Recovery
of driving ability may take six weeks if the surgery
has been performed on the right shoulder, because of
the increased demands on the right shoulder for shifting
gears.
With the consent of their surgeon, patients can often
return to activities such as swimming, golf and tennis
at six months after their surgery. |
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