Shoulder Frequently Asked Questions
- What is arthritis?
- Why does my shoulder hurt?
- What are the benefits of joint replacement?
- What is a total shoulder replacement?
- How long does the typical shoulder implant last?
- Do implants fail and can they be replaced?
- What are my non-surgical options before considering joint replacement?
- When should I have total shoulder replacement surgery?
- Is age a consideration for joint replacement?
- What can I expect from the surgical procedure?
- Can I expect to regain full motion of my shoulder after surgery?
- How long and where will my incision be?
- Will I notice anything different about my new shoulder?
- Are there risks from surgery?
- How can I prepare for surgery?
- What type of rehabilitation can one expect following surgery?
- What activities are acceptable after surgery and what activities should I avoid?
- How long until I can resume my regular activities after surgery?
- When will I be able to return to work?
- Are regular visits with your surgeon required after surgery?
Arthritis is a term that is defined as inflammation of a joint and used to describe over 100 different conditions that can affect the human body. Arthritis affects millions of Americans each year with symptoms including pain, stiffness, swelling, and loss of motion in affected joints.
The bones in a joint are covered with a tough, lubricating tissue called cartilage to help provide smooth, pain-free motion to the joint. As the layer of cartilage wears away, bone begins to rub against bone, causing the irritation, swelling, stiffness, and discomfort commonly associated with arthritis.
The purpose of a joint replacement is to help restore pain-free or near pain-free movement to a joint. Activities that could not be performed before surgery may be resumed as directed by your surgeon after total joint replacement surgery. Your orthopedic surgeon may have several patients who would be willing to speak with you about their experiences before and after total joint replacement surgery. Ask your orthopedic surgeon about this beneficial resource.
Total shoulder replacement involves removing the arthritic humeral head (ball) and replacing it with a metal ball and resurfacing the glenoid (socket) with polyethylene (plastic). The implants are designed to create a new, smoothly functioning joint that prevents painful bone-on-bone contact.
A total joint implant’s longevity will vary from patient to patient. All implants have a limited life expectancy depending on an individual’s age, weight, activity level, and medical condition. It is important to remember that an implant is a medical device that is subject to wear, which may lead to mechanical failure. Following all of your surgeon’s recommendations after surgery may enhance longevity, there is no guarantee that your particular implant will last for any specific length of time.
Since implants are mechanical devices, they are subject to conditions that can lead to mechanical failure. The most common reason for implant failure in shoulder replacements is implant loosening or implant wear that leads to loosening. Implant wear particles can react with the bone, causing thinning of the bone that can lead to implant loosening. In most cases, failed implants can be revised successfully to provide good results.
- Exercise or physical therapy can strengthen the muscles around the affected joint(s), possibly providing relief from pain while improving mobility and function.
- Medical management including nonsteroidal anti-inflammatory medications or steroid injections may assist in reducing painful joint inflammation and restoring function.
Your surgeon will evaluate your health history, perform a physical examination, and take x-rays to decide if you are a candidate for this surgery. You must then decide if your discomfort, pain or stiffness, and overall loss of quality of life justify undergoing surgery. Generally, there is no harm in waiting to have surgery if conservative, non-surgical treatments are effective.
Age is not a problem if you are in reasonably good health and have the desire to continue living a productive, active life. You may ask to see your personal physician for an opinion about your general health and readiness for surgery.
- Operation- approximately 1 ½ to 2 hours
- Hospitalization- usually 1 to 3 days
- Rehabilitation-usually up to 12 months of regular exercise at home. This will vary with each patient and with each surgeon.
After surgery, patients usually gain additional range of motion previously lost to the diseased joint. It is important to remember that the soft tissues play an important role in shoulder movement. Damaged or unrepairable soft tissues in the shoulder will have an affect on unrestricted movement of the shoulder after surgery. Proper preoperative and postoperative physical therapy will also affect the desired surgical outcome. It is important to talk with your physician prior to surgery so he or she can evaluate your condition and give you a better understanding of what you can expect after the surgical experience.
The incision is approximately three inches long, usually made of the front of the shoulder to gain access to the joint.
Yes, you may have some numbness on the outside of the scar. The area around the scar may feel warm. You may also notice some clicking when you move your shoulder as a result of the artificial surfaces coming together.
While uncommon, complications can occur during and after surgery. Some complications include infection, blood clots, implant breakage, nerve damage, fracture, and premature wear. Although implant surgery is extremely successful in most cases, some patients still experience stiffness and pain. No implant will last forever and factors such as the patient’s post-surgical activities and weight can affect longevity. Be sure to discuss these and other risks with your surgeon.
There are many things that your surgeon may do to minimize the potential for complications. Your surgeon may have you see a medical physician before surgery to obtain tests. You may also need to have your dental work up to date and may be shown how to prepare your home to avoid falls.
Proper preparation and a great attitude are the best ways to accomplish a rapid recovery from joint replacement. With the help of a physical therapist, get yourself as physically fit as you can before surgery. Proper nutrition and optimal medical condition can help avoid complications. See your physician prior to surgery to ensure your blood pressure, heart, and lungs are in good shape. Be prepared to continue with your exercise program after surgery.
Exercise is necessary for proper healing. You will begin moving your shoulder within the first 48 hours after surgery. Early movement is important to prevent the muscles in the shoulder from becoming tight. The types of exercises you may perform are gentle, range of motion exercises designed to help restore motion to the muscles in the shoulder. As your rehabilitation continues, you may begin strengthening exercises that are designed to restore strength to your shoulder.
A regular exercise program at home to promote strengthening and mobility will continue up to 12 months following surgery. It is important to follow your surgeon’s prescribed recovery outline. Do not attempt exercises that are not prescribed by your surgeon, and do not attempt to alter your exercise schedule without contacting your surgeon.
Although total shoulder replacement is designed to restore motion and decrease pain, it does not return your shoulder to “normal.” Like any mechanical device, it can wear out with use. Activities like heavy lifting or manual labor can cause early wear and failure of the shoulder implant. Many activities should not begin until the soft tissues around the shoulder heal, which can take 3 to 6 weeks. All postoperative activities should be cleared with your surgeon.
Patients with total shoulder replacement typically require several weeks before returning to any type of lifting or repetitive movement activities. Driving can normally be resumed in 2 to 6 weeks after surgery but only if your doctor indicates and you are not taking any pain medication. Talk to your doctor before participating in an activity that may place excess stress or movement on your shoulder. Consult with your surgeon or therapist for advice on acceptable activities.
Returning to work depends on your type of work. Return to work can be as early as 2 to 6 weeks for sedentary jobs. Returning to a job that requires significant use of the arm will usually take at least three months. Office workers often return in 2 to 3 weeks, while patients with more strenuous jobs may require more time away from work. The timing of your return to work depends considerably upon your commitment to recovery.
The surgeon will set a follow-up schedule for the first year after surgery to evaluate your progress. Usually these follow-ups occur three, six and nine months after the surgery. Annual visits may be required thereafter. Complications can occur with implants, so seeing the surgeon when you notice a change in symptoms can assist in evaluating any changes that may occur with your new joint.
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