Everything You Need to Know Before Shoulder Replacement Surgery

Although we do our best to take care of our bodies, injuries still happen. Because of the stress we put our bodies through on a daily basis, many people will experience shoulder issues, especially if they were an athlete at some point in their life. If you have injured your shoulder and are on a road to discussing a shoulder replacement, you have come to the right place! 

The shoulder is a ball-and-socket joint. The round head (ball) of the upper arm bone fits into a shallow socket in the shoulder. Damage to the joint can cause pain, weakness and stiffness. Shoulder implants are available in a few different shapes and a range of sizes. Replacement options include partial and total using either anatomic or reverse implants. Shoulder replacement surgery is done to relieve pain and other symptoms that result from damage to the shoulder joint. A shoulder replacement removes damaged areas of bone and replaces them with parts made of metal and plastic (implants). This surgery is called shoulder arthroplasty.

Conditions that can damage the joint include:

• Osteoarthritis - known as wear-and-tear arthritis, osteoarthritis damages the cartilage that covers the ends of bones and helps joints move smoothly.
• Rotator cuff injuries - the rotator cuff is a group of muscles and tendons that surround the shoulder joint. Rotator cuff injuries sometimes can result in damage to cartilage and bone in the shoulder joint.
• Fractures - fractures of the upper end of the humerus may require replacement, either as a result of the injury or when the prior surgery for fracture fixation has failed.
• Rheumatoid arthritis and other inflammatory disorders - caused by an overactive immune system, the inflammation associated with rheumatoid arthritis can damage the cartilage and occasionally the underlying bone in the joint.
• Osteonecrosis - some types of shoulder conditions can affect blood flow to the humerus. When a bone is starved of blood, it can collapse.

Depending on the type of joint damage you have, your doctor may recommend one of the following shoulder replacement options:

• Anatomic total shoulder replacement - both the ball and the socket are replaced. The implants resemble the natural shape of the bones.
• Reverse total shoulder replacement - both the ball and the socket are replaced, but the implants are reversed. The ball is attached to the shoulder blade and the socket is attached to the upper arm bone. This option typically is preferred if the rotator cuff is severely damaged.
• Partial shoulder replacement - only the head (ball) of the joint is replaced. It may be recommended when only the ball side of the joint is damaged.

Before your surgery is scheduled, you'll meet with your surgeon for evaluation. Usually this will happen in a series of visits over a period of 3-6 months. During this time, your doctor will work with you to manage your pain and strengthen the surrounding area.

These visits typically include:

• A review of your symptoms
• A physical exam
• X-rays, MRI, and CT of your shoulder
• A physical therapy prescription 
• Some prescription medications to reduce inflammation and pain

Some questions you may want to ask your surgeon:

• What type of surgery do you recommend?
• How will my pain be managed after surgery?
• How long will I have to wear a sling?
• What kind of physical therapy will I need?
• How will my activities be restricted after surgery?
• Will I need to have someone help me at home for a while?
• What should I wear after surgery?

Other members of the care team will assess your readiness for surgery. You'll be asked about your medical history, your medicines and whether you use tobacco. Tobacco interferes with healing.

Because of insurance requirements, and because no surgeon wants to cut unless they have to, you will most likely be referred to a physical therapist who will explain how to do physical therapy exercises and how to use a type of sling (immobilizer) that prevents your shoulder from moving.

Currently, many people leave the hospital the same day of the shoulder replacement procedure, which means recovery is happening at home, and you need to be on top of your recovery care. Reboundwear tops take the stress out of dressing post surgery, making frequent changes less painful and less of a hassle. 

What can you expect?

Before the procedure

Make sure you have been keeping up with your physical therapy exercises to have the best healing results. Follow your surgeon's directions about bathing, eating and taking medicines the days before and the day of surgery.

During the procedure

A team member will talk with you about how you'll be sedated for surgery. Most people get general anesthesia and a nerve block. General anesthesia puts you into a deep sleep. The nerve block numbs your shoulder so that pain control can continue after you wake up from general anesthesia. The surgery usually takes 1 to 2 hours.

After the procedure

After surgery, you'll rest in a recovery area for a short time. X-rays will be obtained. Your shoulder will be in an immobilizer. Don't try to move your shoulder unless you're told to do so.

How long you stay after surgery depends on your individual needs. Most people go home that same day.

After shoulder replacement, most people have less pain than they did before surgery. Many have no pain. Most people also have improved range of motion and strength!