Shoulder Replacement Surgery: Preparation, Procedure, and Recovery

Shoulder problems can be a real pain – quite literally. For individuals suffering from chronic shoulder pain, stiffness, or severe injuries, the prospect of regaining mobility and comfort can be a game-changer. One of the solutions on the table is shoulder replacement surgery, a remarkable medical procedure that can transform the lives of those affected.

What is shoulder replacement surgery?

Shoulder replacement surgery is a highly effective orthopedic procedure designed to relieve pain and restore function in a damaged or deteriorating shoulder joint. This surgery involves replacing the damaged parts of the shoulder with artificial components, effectively creating a new joint. It's a surgical option that provides relief for conditions such as osteoarthritis, rheumatoid arthritis, and severe fractures.

The three types of shoulder replacement

Shoulder replacement surgery comes in three main forms: total shoulder replacement, partial shoulder replacement, and reverse total shoulder replacement surgery. 

Total shoulder replacement 

This is the most common type, involving the replacement of both the ball and socket of the shoulder joint. It's suitable for patients with arthritis or severe joint damage.

Partial shoulder replacement surgery

In this variant, only the damaged part of the shoulder joint is replaced, usually the ball. It's a choice for those with specific conditions that haven't affected the socket.

Reverse total shoulder replacement surgery

This is a specialized procedure for patients with complex conditions like irreparable rotator cuff tears. It reverses the roles of the ball and socket components, allowing for improved stability and function.

The best shoulder replacement surgery

The “best” type of shoulder replacement surgery depends on your specific condition and needs. Your orthopedic surgeon will recommend the most suitable procedure after a thorough evaluation. The success of the surgery also heavily depends on the surgeon's expertise. Therefore, finding the best orthopedic surgeon is paramount. Look for a surgeon with a strong track record in orthopedic procedures and shoulder replacements.

How to prepare for shoulder replacement surgery

The preparation should begin with a consultation with an experienced orthopedic surgeon. During this initial meeting, your surgeon will assess your specific condition and medical history. Be prepared to provide detailed information about your symptoms, previous injuries, and any existing medical conditions.

Medical evaluation

Your surgeon may order imaging tests, such as X-rays, MRIs, or CT scans, to evaluate the extent of damage to your shoulder joint, which will help your surgeon to plan the surgery effectively. Moreover, you’ll go through a comprehensive medical evaluation to ensure that you are fit for surgery. This includes blood tests, EKG, and other relevant tests to assess your overall health.

It’s also crucial to discuss all the medications you are currently taking with your surgeon. Some medications may need to be adjusted or temporarily stopped before the surgery.

To enhance your post-surgery recovery, your surgeon may suggest specific exercises to strengthen the muscles around your shoulder. Maintaining good physical conditioning will help with rehabilitation. In addition, it’s always a good idea to discuss post-operative rehabilitation with your surgeon and physical therapist. Knowing what to expect during the recovery phase will help you mentally and physically prepare for the journey ahead.

Personal preparation

Make sure that your home is ready for your return after the surgery. Prepare your living space by making it safe and accessible: clear any clutter, secure rugs, and arrange essential items at waist level to avoid reaching or straining.

Your surgeon will inform you about any medical equipment you might need post-surgery. This could include a sling, ice packs, or assistive devices for bathing and dressing.

Arrange for a support system, including family or friends, to assist you during the initial days after the surgery. You may need help with daily activities like cooking, cleaning, and transportation.

How shoulder replacement surgery is performed

While shoulder replacement surgery may seem complex, the skill and expertise of orthopedic surgeons, along with advances in medical technology, have made it a highly successful procedure for relieving pain and restoring shoulder function for those suffering from conditions like osteoarthritis, rheumatoid arthritis, or severe fractures. Let's break down how this surgical marvel is performed in a simplified manner.

Anesthesia

The surgery begins with the administration of general anesthesia, ensuring you're comfortable and pain-free throughout the procedure.

Incision and accessing the joint

Once you are under anesthesia, your orthopedic surgeon will make an incision over the shoulder. The location and size of the incision will vary depending on the specific type of shoulder replacement being performed.

With the incision made, your surgeon carefully separates the muscles and tissues to gain access to the shoulder joint. This is a delicate process, as it's essential to minimize damage to the surrounding structures.

Removal of damaged parts

In a total shoulder replacement surgery, both the ball (the humeral head) and the socket (the glenoid) are replaced. Your surgeon begins by removing the damaged or arthritic parts of your shoulder joint.

Preparing the bone

The next step involves preparing the bone to receive the prosthetic components. This may include shaping the bone to ensure a secure fit for the artificial components.

Attaching prosthetic components

Highly specialized prosthetic components made of metal, plastic, or a combination of materials are then securely anchored to the bone. The humeral component replaces the ball, while the glenoid component replaces the socket. These components mimic the natural structure of the shoulder joint.

Testing and alignment

Your surgeon will test the new joint's alignment and functionality to ensure it moves smoothly and without issues. Proper alignment is crucial for the long-term success of the surgery.

Closing the incision

Once the prosthetic components are securely in place, your surgeon carefully closes the incision with stitches or surgical staples. The incision is typically sutured in layers to promote proper wound healing.

Shoulder replacement recovery

Recovery after shoulder replacement surgery is a crucial phase in the journey toward regaining shoulder function and relieving pain. The process is gradual, and it's essential for patients to follow post-operative care instructions carefully. 

Immediately after surgery

Right after the surgery, you will be moved to a recovery area, where you'll be monitored closely. Once you're fully awake and stable, you'll be discharged to go home.

Pain management is a top priority, so your doctor will prescribe medication to keep you comfortable during the early post-operative period.

Week 1-2

You will likely wear a shoulder sling to immobilize the joint and protect it. Your surgeon will determine the duration and type of immobilization.

Early rehabilitation usually begins within a week. A physical therapist will guide you through gentle range-of-motion exercises. These exercises help prevent stiffness and maintain some movement in the shoulder.

Week 3-6

As you progress, physical therapy will shift to more intensive exercises to strengthen the shoulder muscles. The focus is on improving range of motion and regaining strength.

Week 6-12

By this time, you may begin to engage in light activities of daily living, but avoid heavy lifting or strenuous activities.

Month 3-6

Most patients can expect to have close to a full range of motion in their shoulder at this stage. And depending on your occupation, you may be able to return to work around this time. Your surgeon and therapist will provide guidance.

What you need to do during the shoulder replacement recovery period

• It's crucial to follow your surgeon's and physical therapist's instructions diligently. This includes taking medications as prescribed, wearing the sling or brace, and doing your exercises regularly.
• Regular follow-up appointments with your surgeon are essential to monitor your progress and make any necessary adjustments to your rehabilitation plan.
• Continue to manage pain and swelling as needed, and report any unusual or severe symptoms to your healthcare team.
• Maintain a balanced diet and stay hydrated to support your body's healing process. Avoid smoking, as it can impede healing.
• Adequate rest and sleep are vital for recovery. Listen to your body and avoid overexertion.
• Recovery after shoulder surgery is a journey that requires patience and persistence. Progress can be slow, but the ultimate goal is to regain pain-free shoulder function.

Risks of delaying shoulder replacement surgery

Delaying shoulder replacement surgery can have several risks and consequences for individuals suffering from debilitating shoulder conditions. While it's important to weigh the potential risks and benefits with your orthopedic surgeon, we will share some risks associated with postponing this type of surgery.

Increased pain and discomfort

The primary reason people consider shoulder replacement surgery is to relieve chronic pain and discomfort caused by conditions like osteoarthritis or severe joint damage. Delaying surgery means prolonging this pain, which can significantly affect one's quality of life.

Progression of joint damage

Many shoulder conditions are progressive, meaning they worsen over time. Delaying surgery can allow these conditions to progress, leading to more extensive joint damage. This may make the surgery more complicated and reduce the chances of a successful outcome.

Loss of function

As joint damage worsens, the shoulder's range of motion and functional ability can deteriorate. Delaying surgery can lead to a further loss of function, making everyday activities challenging or impossible.

Risk of complications

In some cases, delaying surgery can increase the risk of complications during the procedure. For example, if the shoulder joint becomes severely damaged, it may be more challenging to achieve optimal results with a replacement.

Longer rehabilitation

After shoulder replacement surgery, the recovery process can be lengthy. Delaying surgery means a longer period before you can start rehabilitation and regain function, potentially delaying your return to normal activities.

Discuss shoulder replacement surgery with the best orthopedic surgeons on PreferredMD

Shoulder replacement surgery is a major step toward regaining the quality of life for those suffering from debilitating shoulder conditions. It offers hope, relief, and a return to an active lifestyle. The key to a successful outcome lies in proper preparation, choosing the right procedure, and having a highly skilled orthopedic surgeon to guide you through the process. While there are risks associated with the surgery, the potential benefits often outweigh them, allowing patients to once again enjoy the freedom of pain-free movement.