While shoulder replacement surgery is less common than knee or hip replacement, more than 100,000 shoulders are replaced each year in the United States. If you’re scheduled to have a shoulder replacement, learning what to expect can help you prepare.
Like its joint replacement counterparts for the hips and knees, shoulder replacement surgery is typically very effective in reducing pain and improving quality of life. When other treatment options, such as anti-inflammatory medications, corticosteroid injections and activity modification are no longer helping, shoulder replacement may be the solution.
A peek inside the anatomy of the shoulder
You use your shoulders all the time, but probably don’t think about them much—unless they’re causing you pain. Understanding the parts that make up the shoulder can help you understand what’s behind your joint pain.
The shoulder contains three bones: the humerus, which is the upper arm bone, the scapula, which is the shoulder blade, and the clavicle, which is the collarbone. The shoulder joint is
what’s called a “ball-and-socket” joint (glenohumeral joint), whereas where the clavicle and scapula meet is generally referred to as the ac (acromioclavicular) joint.
The bones in your shoulder are covered with cartilage, and all other surfaces are covered by the joint lining, called the synovium. The shoulder also contains muscles and tendons that help support it.
All of these components come together to give the shoulder joint a greater range of motion than any of the hundreds of other joints in the body.
When is shoulder replacement surgery recommended?
If you’re experiencing shoulder pain that makes it difficult to move your arm, shoulder replacement surgery may be the next step. Shoulder replacement may be recommended if your shoulder is damaged by:
- Osteoarthritis
- Osteonecrosis (the death of bone)
- Previous shoulder surgery, including failed shoulder replacement
- Rheumatoid arthritis
- Severe fractures of the arm
- Severely damaged or torn shoulder tissue
- Tumors in the shoulder or around it
What happens during shoulder replacement surgery?
There are multiple types of shoulder replacement surgery. An orthopedic surgeon will recommend the best type based on which parts of the shoulder are damaged:
- Total shoulder replacement – removes and replaces both the ball and the socket.
- Partial Shoulder replacement – only the ball OR socket are removed and replaced.
- Reverse total shoulder replacement – Another type of shoulder replacement that may be used in cases where there is severe damage to the rotator cuff or a humeral head fracture. In this procedure, both the ball and the socket are replaced, but their placement in the shoulder is switched, attaching the ball to the scapula and the socket to the humerus. This allows the arm to rely on the deltoid muscle for lifting rather than the damaged rotator cuff.
How to prepare for shoulder replacement surgery
As you get ready for shoulder replacement surgery, the first step is presurgical testing. This provides a thorough look at whether you’re healthy enough to undergo surgery, using tools such as blood work, an electrocardiogram and imaging scans.
Once you’re cleared for surgery, you’ll be provided with instructions for how to prepare. These instructions will cover topics like:
- Fasting prior to the procedure
- Using special disinfectant before surgery
- How and whether to take your medications leading up to surgery
- When to arrive at the hospital or surgery center
Carefully following these guidelines is important for ensuring you’ll stay safe and healthy during and after surgery.
What to expect after shoulder replacement surgery
Shoulder replacement surgery usually takes between one and three hours, depending on the exact procedure and the extent of the damage. The anesthesiologist may offer a nerve block prior to surgery, which will essentially numb the operative arm for 18-24 hours. Following surgery, you’ll be moved to a recovery room where your vital signs and other aspects of your health will be closely monitored.
Depending on the type of shoulder replacement, you may receive some gentle range-of-motion exercises to perform after surgery, followed by outpatient physical therapy when appropriate.
Following shoulder replacement surgery, your arm will be placed in a sling for two to six weeks. The sling helps protect your shoulder from jostling and other movements that can cause injury. Wear the sling as directed by your care team, removing it only when advised.
You may be discharged home on the same day as your surgical procedure or kept overnight for observation, at your surgeon’s discretion. When you’re discharged home, you and your caregivers will be given a lengthy set of instructions to guide your at-home recovery.
The aftermath of shoulder replacement surgery can be painful, so it’s important to stay ahead of your pain by taking pain medications as directed. You may not notice the pain much while in the hospital since the nerve block may still be wearing off, so don’t be alarmed if more pain emerges in the hours after you get home.
Most patients are able to resume many activities, including independently eating and grooming, within a week or two after shoulder replacement surgery. Your surgeon will advise as to when you can resume other activities, such as driving and working.
Once your postsurgical recovery is complete, you may revel in having a new and improved shoulder. Take good care of it to keep it working well for the long run!
Next steps
Orthopedic Services at Northeast Georgia Medical Center offers comprehensive joint replacement services, including shoulder replacement. Fill out the quick form on our website to get started.