Total Shoulder Replacement

Realistic Expectations

An important factor in deciding whether to have shoulder replacement surgery is understanding what the procedure can and cannot do. Most people who undergo shoulder replacement surgery experience a dramatic reduction of shoulder pain and a significant improvement in their ability to perform the common activities of daily living.

With appropriate activity modification, shoulder replacements can last for many years. Normal use and activity begins to wear the material between the head and the socket of every shoulder replacement implant. Excessive activity or lifting may speed up this normal wear and cause the shoulder replacement to loosen and become painful.

Some swelling around the joint is the norm in the weeks and months after surgery. Rehabilitation will to accelerate your recovery and often allows patients to reach the top of their head or up to a high shelf comfortably. Patient satisfaction following total shoulder replacement and reverse shoulder replacement is typically very high

Home Planning

Several modifications can make your home easier to navigate during your recovery. It will be difficult to reach over head items from high shelves and cupboards for the first few weeks following surgery.

• Secure handrails along all stairways.
• A stable chair for your early recovery with a firm seat cushion and a firm back that will allow you to stand without needing your surgical arm.
• Place any items that you may need on low shelves that will be easier to reach
• A stable shower bench or chair for bathing.
• A long-handled sponge and shower hose.
• A dressing stick, a sock aid, and a long-handled shoe horn for putting on and taking off shoes and socks.
• A reacher that will allow you to grab objects.
• Removal of all loose carpets and electrical cords from the areas where you walk in your home.

Protecting Your Shoulder Replacement

There are many things you can do to protect your shoulder replacement and extend the life of your implant.

• Participate in a regular light exercise program to maintain proper strength and mobility of your new shoulder.
• Take special precautions to avoid falls and injuries. If you break a bone in your arm, you may require more surgery.

See your orthopaedic surgeon periodically for routine follow-up examinations and x-rays, even if your shoulder replacement seems to be doing fine.

How Is Your New Shoulder Different?

You may feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive activity. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery.

Your new shoulder may activate metal detectors required for security in airports and some buildings. Tell the security agent about your shoulder replacement if the alarm is activated.

What are Shoulder Precautions?

Shoulder Precautions are positions you should avoid with your surgical arm to prevent dislocation of the artificial shoulder.

• Keep your arm in front of you and in a sling until directed by your surgeon.
• Do not lift greater than 25lbs
• Do not push yourself up with your surgical arm
• Do not turn feet excessively outward (externally rotate the shoulder).

Potential Complications

The complication rate following shoulder replacement surgery is low. Serious complications, such as joint infection, occur in less than 2% of patients. Major medical complications, such as heart attack or stroke, occur even less frequently. However, chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur they can prolong or limit full recovery. The following are other risks related to hip replacement surgery:

• Infection
• Blood Clots
• Shoulder Stiffness
• Dislocation
• Loosening and Implant Wear

Activity After Surgery

Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal light activities of daily living within the weeks following surgery. Some discomfort with activity and at night is common for several weeks.

Your activity program should include:

• A graduated motion program to slowly increase your mobility.
• Resuming other normal household activities, such as sitting, standing, and hygiene.
• Specific exercises several times a day to restore movement and strengthen your shoulder.

You probably will be able to perform the exercises without help, but you may have a physical therapist help you at home or in a therapy center the first few weeks after surgery.

Sexual Relations

Many patients are concerned with the safe positions for sexual intercourse after shoulder replacement. In general, sexual activity may resume in the weeks following surgery. Positions that do not adhere to Shoulder Precautions increase the risk for dislocation of the replacement.

Never hesitate to ask your doctor questions when you do not understand. The more you know, the better you will be able to manage the changes that hip replacement surgery will make in your life.