Shoulder replacement

 

Alternative Names

Total shoulder arthroplasty; Endoprosthetic shoulder replacement; Partial shoulder replacement; Partial shoulder arthroplasty; Replacement - shoulder; Arthroplasty - shoulder

Definition

Shoulder replacement is surgery to replace the bones of the shoulder joint with artificial joint parts.

Why the Procedure Is Performed

Shoulder replacement surgery is usually done when you have severe pain in the shoulder area, which limits your ability to move your arm. Causes of shoulder pain include:

Your doctor may not recommend this surgery if you have:

  • History of infection, which can spread to the replaced joint
  • Severe mental dysfunction
  • Unhealthy skin around the shoulder area
  • Very weak (rotator cuff) muscles around the shoulder that cannot be fixed during surgery

Risks

Risks of any anesthesia are:

Risk of any surgery are:

Risks of shoulder replacement surgery are:

  • Allergic reaction to the artificial joint
  • Blood vessel damage during surgery
  • Bone break during surgery
  • Nerve damage during surgery
  • Dislocation of the artificial joint
  • Loosening of the implant over time

Before the Procedure

Tell your doctor or nurse what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

  • Two weeks before surgery you may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve).
  • Ask your doctor which medicines you should still take on the day of your surgery.
  • If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
  • Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
  • If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow down wound and bone healing.
  • Let your doctor know right away if you get a cold, flu, fever, herpes breakout, or other illness before your surgery.

On the day of your surgery:

  • You will likely be asked not to drink or eat anything for 6 - 12 hours before the procedure.
  • Take the medicines your doctor told you to take with a small sip of water.
  • Your doctor or nurse will tell you when to arrive at the hospital. Be sure to arrive on time.

After the Procedure

  • You may stay in the hospital for 1 - 3 days after your surgery.
  • While there, you may receive physical therapy to help keep the muscles around your shoulder from getting stiff.
  • Before you go home, the physical therapist will teach you how to move your arm around by using your other (good) arm to help.
  • Your arm will need to be in a sling for 2 - 6 weeks with no active movement and 3 months before strengthening. It will be around 4 - 6 months of recovery.
  • Follow any instructions you are given about how to care for your shoulder at home. This includes activities that you should not do.
  • You will be given instructions on shoulder exercises to do at home. Follow these instructions exactly. Doing the exercises in a wrong way can injure your new shoulder.

Outlook (Prognosis)

Shoulder replacement surgery relieves pain and stiffness for most people. You should be able to resume your normal daily activities without much problem. Many people are able to return to sports such as golf, swimming, gardening, bowling, and others.

Your new shoulder joint will last longer if less stress is placed on it. With normal use, a new shoulder joint can last for at least 10 years.

References

Azar FM, Calandruccio JH. Arthroplasty of the shoulder and elbow. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, PA: Elsevier Mosby; 2007:chap 8.

Goldberg VM, Kraay MJ. Surgical treatment of joint diseases. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, PA: Elsevier Mosby; 2007:chap 299.

Izquierdo R, Voloshin I, Edwards S, et al. Treatment of glenohumeral osteoarthritis. J Am Acad Orthop Surg. 2010;18(6):375-82.

Review Date: 11/15/2012
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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