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total shoulder replacement
 Why replace the shoulder?
What is total shoulder replacement?
Preparing for surgery
The surgery
After surgery
Why replace the shoulder?
A stiff, painful shoulder can keep the patient from doing even simple things, like dressing themselves or carrying groceries. A worn-out shoulder can be replaced just as a bad hip or knee can be. Shoulder replacement is safe and reliable. Surgery almost always relieves pain, may give more strength and movement in the shoulder, and may let the patient return to many normal activities.
What is total shoulder replacement?
During surgery, our orthopedic surgeon replaces all or part of the problem shoulder with an artificial joint. This artificial joint replaces the rough, worn parts of the shoulder with smooth metal and plastic parts.
Preparing for surgery
Replacement surgery is necessary only if other treatment options do not relieve the symptoms.
Evaluation before the surgery
- Patients are generally asked to see their primary care physician for a general exam.
- The anesthesiologist will also evaluate the patient prior to the operation and discuss the type of anesthetic to be used.
- Routine tests are performed a week before surgery. These help establish if the patient is fit for surgery.
Precautions before the surgery
- Aspirin or other medications containing aspirin, or anti-inflammatories should be discontinued 1 to 2 weeks before surgery to minimize bleeding.
- If you are on a blood thinner, such as Coumadin, it should be discontinued at least several days prior to surgery, in consultation with your prescribing doctor.
- It is important to take vitamins and iron supplements before and after the operation.
- If you smoke, stop smoking.
- Shoulder surgery will not be performed when active infections are present elsewhere in the body, such as bladder or skin.
The surgery
Depending on its complexity, the operation itself usually takes 2 to 3 hours. The surgeon may replace just the ball (partial replacement) or both the ball and the socket (total replacement). An incision about 6 inches long is made from the collarbone to the arm.
Partial Replacement:
- The humeral head is removed and the arm bone is prepared to hold the stem. The stem may be cemented into the bone. The metal ball is secured to the new stem.
- If the shoulder has been fractured, the tuberosities are fixed to the new stem and to the bone around it.
Total Replacement:
- The worn humeral head is removed and the arm bone is prepared to hold the stem.
- Then the glenoid is prepared. Usually the plastic cup is cemented in place.
- The stem is inserted into the arm bone and the metal ball is secured to the new stem.
Once the new joint is in place, the surgeon closes the incision with staples or sutures.
After surgery
Most patients will be discharged from the hospital 2 to 3 days after shoulder surgery, depending on their age and physical ability. The arm may be placed in a sling or other support to protect the shoulder and keep it comfortable. The arm may be bruised and swollen.
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