Shoulder Replacement

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

Definition

A shoulder replacement is surgery to replace a diseased or injured shoulder. An artificial ball-and-socket joint is inserted to make a new shoulder.

EQ00020_shoulder replacement

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Reasons for Procedure

This surgery is done to ease shoulder pain in people who are not helped by other methods. It is also done when pain and stiffness limit normal activities.

It may be done to treat a broken shoulder, shoulder injuries, severe arthritis, and loss of blood supply to the bones of the shoulder.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Shoulder stiffness
  • Shoulder instability
  • Injury to surrounding structures like the nerve, blood vessels, and shoulder joint

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery, such as images of the shoulder

Anesthesia

The doctor may give:

Description of the Procedure

This can be done using open surgery or using a minimally invasive technique.

Open Surgery

An incision will be made along the joint. The muscles will be moved aside. Another incision will be made in the rotator cuff. This is the group of tendons that cover and support the shoulder joint. The damaged bone and cartilage of the shoulder joint will be removed. The remaining bone will be prepared for the artificial joint. The artificial joint will be put in place. Bone cement may be used to hold one or both parts of the artificial shoulder to the bone. The incision will be closed with stitches or staples. A drain may be inserted to remove fluids that may build up. A bandage will be placed over the area.

Minimally Invasive Technique

A few small incisions will be made. Tools will be passed through these incisions. Images may be taken to help guide surgery. The muscles will be moved aside. Another incision will be made in the rotator cuff. This is the group of tendons that cover and support the shoulder joint. The damaged bone and cartilage of the shoulder joint will be removed. The remaining bone will be prepared for the artificial joint. The artificial joint will be put in place. Bone cement may be used to hold one or both parts of the artificial shoulder to the bone. The tools will be removed. The incision will be closed with stitches or staples. A drain may be inserted to remove fluids that may build up. A bandage will be placed over the area.

How Long Will It Take?

A few hours

Will It Hurt?

Pain and swelling are common in the first few weeks. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 2 to 3 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give you pain medicine
  • Give you medicine to prevent blood clots
  • Raise the shoulder to ease swelling
  • Apply ice to the area
  • Put your arm in a sling to support the shoulder
  • Do X-rays to check the new shoulder joint

Physical therapy will be started soon after the procedure.

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

You can also lower your chance of infection by:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

Physical activity will be limited during recovery. You may need to ask for help with daily activities and delay your return to work for a few weeks. It will take about 8 weeks before you can begin light activities.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Nausea or vomiting
  • Pain that is not eased by medicine
  • Cough, shortness of breath, or chest pain
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incisions
  • Numbness or tingling in the arm, shoulder, or hand

If you think you have an emergency, call for medical help right away.

RESOURCES:

Ortho Info— American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES:

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

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

REFERENCES:

Arthroplasty. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/arthroplasty_92,P07677. Accessed September 30, 2020.

Joint replacement: shoulder. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/treatments_and_procedures/hic_Total_Shoulder_Joint_Replacement. Accessed September 30, 2020.

Osteoarthritis (OA) of the glenohumeral joint. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/osteoarthritis-oa-of-the-glenohumeral-joint. Accessed September 30, 2020.

Shoulder joint replacement. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00094. Accessed September 30, 2020.

Shoulder replacement. Hospital for Special Surgery website. Available at: https://www.hss.edu/conditions_Shoulder-Replacement-Surgery-Diagnosis-Treatment-Recovery.asp. Accessed September 30, 2020.

van der Meijden OA, Gaskill TR, et al. Glenohumeral joint preservation: a review of management options for young, active patients with osteoarthritis. Adv Orthop. 2012;2012:160923.

Last reviewed September 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM  Last Updated: 9/30/2020