What to Expect With Shoulder Replacement Surgery

Shoulder replacement surgery is a very common procedure that can help individuals with shoulder pain and limited range of motion. Many people suffer from chronic shoulder pain which can limit their range of daily activities. The great news is that shoulder replacement surgery can help get rid of this pain permanently and vastly improve their quality of life. An artificial joint is used during shoulder replacement surgery to replace the injured joint. The surgery is usually done once, but it can be repeated when needed. The surgery is recommended for patients with severe joint pain and a limited motion range, especially the situations that cannot be improved by medication or other forms of treatment including physical therapy.

What are the types of shoulder replacement surgeries?

There are a lot of shoulder replacement surgeries that exist, the three most common types include:

• Total shoulder replacement – This is the type of procedure where the orthopedic surgeon replaces the ball of the humerus bone with a rounded smooth metal implant. Also with this procedure, the damaged cartilage of the socket is removed and replaced with a plastic prosthetic
• Partial shoulder replacement surgery – In this procedure, the orthopedic surgeon leaves the socket of the shoulder joint intact. They only replace the ball of the humerus with a metal prosthetic implant. This procedure is also referred to as shoulder hemiarthroplasty.
• Reverse shoulder replacement surgery – In this procedure, the surgeon reverses the shoulder’s normal structure. The scapula, which is where the socket normally sits, is linked to the spherical metal implant during a reverse shoulder replacement procedure. The artificial socket is attached to the humerus, where the humeral ball usually is. This switch allows the deltoid muscles of the shoulder, which are fairly strong, to take up the responsibility of moving the shoulder joint. This increases the joint’s stability.

What determines the Type of Shoulder Replacement Surgery?

The main deciding factor that determines the type of shoulder replacement surgery an individual will get is the level of damage to their rotator cuff. If there is less damage to the rotator cuff, a total or standard shoulder replacement surgery may be ideal. If there is substantial damage to the rotator cuff because of trauma or due to severe arthritis, the individual may not be a good candidate for total shoulder replacement surgery. Rather a reverse shoulder replacement surgery may be ideal, where the success of the surgery lies on the deltoid muscles instead of the rotator cuff muscles. When the patient has persistent and severe osteoarthritis involving only the humeral head of the shoulder joint, they may be a good candidate for partial shoulder replacement.

Who are the candidates for reverse shoulder replacement?

The surgeon may recommend a reverse shoulder replacement surgery if the patient has any of the following:

• A cuff tear arthropathy
• A complex shoulder joint fracture
• A previously unsuccessful shoulder replacement
• A chronic shoulder dislocation
• A torn rotator cuff that cannot be repaired
• A tumor on the shoulder joint
• Severe shoulder pain on movement of the joint
• Unsuccessful treatments like medication, therapy, or cortisone injections 

What are the potential risks and complications of shoulder replacement surgery?

It is critical to be informed of potential dangers and side effects when thinking about having a shoulder replaced, including infection, nerve damage, blood vessel damage, shoulder dislocation, and implant issues. You should have a full discussion about these risks with your doctor before deciding whether or not to proceed with the procedure. To reduce the chance of difficulties, your doctor will also provide you with detailed instructions for post-operative care. Carefully adhere to these instructions for the best results.

What are the things to expect after a shoulder replacement surgery?

For individuals that are preparing to get the replacement surgery, knowing what to expect can help them have a better outcome. Some things to know about the surgery include:

Managing the pain 

The patient can expect pain after the surgery which is common with other types of surgery. The pain will also gradually decrease as the patient heals. Most people only report mild pain after their recovery and rehabilitation from shoulder replacement surgery. This is usually a great improvement from the usual pain that was experienced before the surgery. It is also important to work closely with the physical therapists to understand the positions and the exercises that will reduce the pain and improve their healing rate. 

The patient should also be in close communication with their surgeon to understand the dosing of pain medications after the surgery. It is also crucial to have a plan to wean off opioid medications. Research has shown that taking prescribed opioids before surgery leads to worse pain management after the surgery. The patient should also consider weaning off these medications before the surgery with the supervision of the health care team. This can help with pain management after the surgery.

Help and assistance

The patient will have the operated arm in a sling for weeks. They will not be able to use the arm for anything except the prescribed exercises during physical therapy. The physical therapist will also teach the patient some specific exercises that will promote healing. The patient should consider having meals that are very easy to prepare. They may also wish to set things that they use regularly in the home at an easy-to-reach level. Also, button-up shirts are the easiest to wear when the arm is immobilized. The patient should also have family and friends over to support them after their surgery.

Difficulty sleeping 

Sleeping may be difficult initially, but will usually improve with good habits. Some good sleeping habits can include: avoiding large meals before bed, having a regular set bedtime, avoiding nicotine, avoiding caffeine before bedtime, and removing electronic devices from the bedroom. Finding a well-supported position will also be important in improving sleep hygiene. They should also consult with their physical therapist about positions that will enable the shoulder to be protected during sleep.

Improved mobility and function 

One of the most critical aspects of recovery after a shoulder replacement surgery is physical therapy. They can even work before the surgery to improve the shoulder and upper back movement to keep the shoulder as strong and mobile as possible till the surgery is done. After the surgery, the physical therapist will also educate and guide the patient about the precautions to take, and the movements to avoid at home during the initial healing phase. They also will teach the patient how to manage the affected arm when doing their daily activities. The physical therapist will also work with the patient to gradually get back their range of motion, improve their strength and function, and eventually help them get back to their everyday activities.