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(Replacement, Total Shoulder; Shoulder Joint Replacement; Replacement, Shoulder Joint; Total Shoulder Joint Replacement; Replacement, Total Shoulder Joint)

Definition

Total shoulder replacement is a surgery done to treat different shoulder conditions and injuries, such as:

During this surgery, the painful, worn shoulder joint is replaced with a new joint made from metal and plastic.

Shoulder Replacement

A metal joint replaces the injured shoulder joint.

Reasons for Procedure

The surgery relieves shoulder joint pain caused by a shoulder condition or injury.

Possible Complications

Problems from the surgery are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Shoulder stiffness
Shoulder instability
Infection
Nerve damage
Loose shoulder joint

Talk to your doctor about these risks before the surgery.

What to Expect

Prior to Procedure

Before surgery, you may meet with your doctor for a physical exam, medical history, and tests. You may have the following done:

Blood tests
X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
Computed tomography (CT) scan —a type of x-ray that uses a computer to make pictures of structures inside the shoulder
Magnetic resonance imaging (MRI) scan —a test that uses magnetic waves to make pictures of structures inside the shoulder

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to two weeks before the procedure like:

Aspirin and other nonsteroidal anti-inflammatory drugs (eg, ibuprofen , naproxen )
Blood-thinning drugs, like warfarin (Coumadin)
Anti-platelet drugs, like clopidogrel (Plavix)
Arthritis medicines

Anesthesia

You will be given general anesthesia or regional anesthesia before surgery begins.

General anesthesia will block pain and keep you asleep through surgery. It is given through a vein in your arm or hand or as a gas through your lungs.

Regional anesthesia blocks pain in a certain part of the body, in this case your upper body. It does not keep you asleep during surgery. It is given through a vein in your arm or hand.

Description of the Procedure

The doctor will make a cut through your skin near your shoulder. The large muscles around the shoulder will be pulled back. She will then make a cut 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.

Immediately After Procedure

You will be taken to the recovery care unit where nurses will monitor you. They will watch your vital signs (eg, blood pressure, pulse, and breathing). X-rays may also be taken.

How Long Will It Take?

A few hours

How Much Will It Hurt?

Anesthesia prevents pain during surgery. As you recover, you may have some pain. Your doctor will give you pain medicine.

Average Hospital Stay

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.

Post-procedure Care

At the Hospital

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.

At Home

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 two weeks after surgery. In the meantime, family members or friends may help you with daily activities.

When you return home, take these steps:

Follow your doctor’s instructions for cleaning the incision site and wearing the arm sling.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
Ask your doctor about when it is safe to drive.
Be sure to follow all your doctor’s instructions.

Call Your Doctor

Call your doctor if any of these occur:

Shoulder stiffness, pain, or instability
Problems at the incision site (eg, bleeding)
Signs of an infections such as fevers or chills

In case of an emergency, call for medical help right away.

RESOURCES

American Academy of Family Physicians http://familydoctor.org/

American Academy of Orthopaedic Surgeons http://www.aaos.org/

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org/

Canadian Orthopaedic Foundation http://www.canorth.org/

References

Shoulder joint replacement. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00094 . Updated October 2007. Accessed September 29, 2011.

Shoulder replacement surgery: diagnosis, treatment, and recovery. Hospital for Special Surgery website. Available at: http://www.hss.org/conditions%5FShoulder-Replacement-Surgery-Diagnosis-Treatment-Recovery.asp . Updated September 25, 2007. Accessed September 29, 2011.

Total shoulder joint replacement. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/shoulder%5Freplacement/hic%5Ftotal%5Fshoulder%5Fjoint%5Freplacement.aspx . Updated July 21, 2009. Accessed September 29, 2011.

Revision Information

Reviewer: John C. Keel, MD
Review Date: 10/2011 -
Update Date: 12/07/2011 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.