What is a Total Shoulder Arthroplasty?

A total shoulder arthroplasty (shoulder replacement) is a surgical procedure in which parts of an arthritic joint are replaced with a prosthesis or artificial parts. The surface of the ball (humeral head) is resurfaced with metal and the socket (glenoid) is resurfaced with plastic. This artificial joint is designed to move like a normal, healthy joint.

How do you replace the shoulder?

The prosthesis will be placed through an incision down the front of the shoulder. The ball component is usually pressed to fit into place while the socket will be cemented.

Length of Stay

You will spend one to two nights in the hospital after this surgery. You will need to have someone to drive you home after you have been discharged.

Anesthesia

Patients usually have two types of anesthesia for this surgery. The first is general anesthesia, which means you are asleep. The second type of anesthesia is a nerve block. Your arm will be numb and will feel very strange. The nerve block will last about 12-14 hours. The anesthesiologist will speak to you on the day of surgery. The ultimate choice of anesthesia technique is up to you and your anesthesiologist.

Incision

You will have an incision down the front of your shoulder. After the incision has healed, it is usually very thin and not very noticeable.

Pain

While admitted to the hospital you will be given oral and IV pain medications. You will also have pain medication prescribed for when you are discharged home.

Sling

Your arm will be placed in a sling prior to leaving the operating room. When you go home you only need to wear the sling for protection, i.e. in a crowded area. No opening or closing doors

Dressings

You will go home with tape and gauze dressings. After 2 days you may remove the dressings. There may be steri strips over the incisions. The steri strips are to remain in place until they fall off on their own. Any sutures will be removed at your first postoperative visit.

Physical Therapy

Before leaving the hospital you will be taught your home exercise program. For the first month of recovery, you will do these very gentle stretches at home. You will then go to physical therapy in months 2 and 3 for more organized care

Blood Thinners

After surgery blood thinners, in most cases, Aspirin, will be prescribed for two weeks. Please take a 325mg aspirin twice each day. This is to prevent blood clots. If you are considered high risk for developing a blood clot or have a history of blood clots, Coumadin or Warfarin may be prescribed About once a week blood will be drawn to make sure the correct dose is prescribed. A medical doctor will follow your lab values and notify you of the results and if your dose needs to be changed. DO NOT TAKE COUMADIN AND ASPIRIN.

Restrictions

Recovery from total shoulder replacement is three months. During that time you will have restrictions on the use of your operative arm. You may drive when you feel that you can properly control a car and you are NOT taking narcotic pain medication. .The full benefit and recovery of shoulder replacement is usually felt over the first 12-24 months

Day of surgery to Week 6: no active reaching and lifting, no closing doors, no reaching behind your back, and no repetitive movements
Week 6-12: progressive stretching and strengthening, no heavy lifting