A Look Inside: Total Shoulder Replacement Procedures – ShoulderMD Blog

Over time, the cartilage, bones, and joints in your shoulder grow old and weak. Arthritis may set in, further weakening your shoulder and making it “rusty”. Pain, swelling, and discomfort are common when this happens. To prevent your damaged shoulder from becoming worse, doctors recommend a total shoulder replacement procedure.

Total shoulder replacement procedures involve replacing all the cartilages, joints and bones of the shoulder. These procedures are only performed if the health of the shoulder is compromised beyond repair and recovery. Doctors look for certain signs and symptoms that your body exhibits, which indicate the necessity of a shoulder replacement surgery. These signs include:

  • Chronic pain and limited mobility in the shoulder
  • Joint stiffness
  • Intense intermittent pain during cold and humid weather
  • Arthritis

If you are experiencing any of the above symptoms, visit your orthopedic surgeon for a consultation.

The Surgery

Total shoulder replacement procedures last up to 3 hours. The surgery involves the following steps:

  • Administration of anesthesia

Usually, a general anesthesia is given to the patient. However, a local anesthesia may be given to the arm and shoulder in addition to the general anesthesia. The type of anesthesia to be given will be determined by the surgeon prior to the surgery.

  • The first incision

The entry incision will be done at the top of the shoulder and down across the deltoid muscle. This will give the surgeon access to the deep tissues and the rotator cuffs, which he/she will then cut, to enter the shoulder joint.

  • Replacement of the humerus and the scapula

The humerus is the upper arm bone and the scapula is the shoulder bone. In most cases, these two bones would have severely worn out, resulting in the need for a shoulder replacement surgery.

The surgeon will use a tool known as the osteotome to remove any spurs that have developed on the bones and joints due to arthritis. A prosthetic humeral stem is placed in the place of the worn-out humerus.

  • Placement of the artificial sockets and prosthetics

The surgeon will use a tool called the reamer to ready the area in and around the scapula for prosthetic fitment. Polyethylene-made prosthetics are placed and secured with the help of bone cement. Press-fit prosthetics, with no cement, may also be used.

Surgical complications

As with any other surgery, there are a few complications that can occur post-surgery. Some of them are:

  • Infection
  • Joint dislocations and fractures
  • Prosthetic misalignment
  • Nerve injury

With proper care and post-surgical treatment, patients can minimize these surgical risks.

Recovery and Healing

Right after surgery, you may experience intense pain in the surgical area. Swelling, redness, and bruising are common. Over time, surgical scars will heal and disappear. During the initial few weeks, you’ll be asked not to tax your shoulder. But, once your shoulder has healed, the physiotherapist will get you started on a few shoulder exercises which you need to perform every day. Initially, these exercises will be gentle, but after 3 months of the surgery, you’ll be subjected to intensive strength training.

Usually, patients go home after 1-3 days of the surgery, depending on their recovery. Medication will be prescribed and in the event of continued fever and pain, you will be advised to return to the hospital. Patients experience limited movement for at least 6 months to a year after the surgery. Seeing a shoulder specialist after the shoulder surgery is advised to ensure the patient’s healing process is going smoothly!

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