Shoulder Replacement

In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis.

The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid).

Cause

Several conditions can cause shoulder pain and disability, and lead patients to consider shoulder joint replacement surgery.

• Osteoarthritis (Degenerative Joint Disease)
• Rheumatoid Arthritis
• Post-traumatic Arthritis
• Rotator Cuff Tear Arthropathy
• Avascular Necrosis (Osteonecrosis)
• Severe Fractures
• Failed Previous Shoulder Replacement Surgery

Shoulder Replacement Options

Shoulder replacement surgery is highly technical. It should be performed by a surgical team with experience in this procedure.

Dr IPS Oberoi Is a speacialist and has performed more than …. Shoulder replacements in over … years

There are different types of shoulder replacements and the type is chosen based on your situation after careful evaluation.

1. Total Shoulder Replacement

The standard total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket. Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.

2. Stemmed Hemiarthroplasty

Depending on the condition of your shoulder, your surgeon may replace only the ball. This procedure is called a hemiarthroplasty.

Some surgeons recommend hemiarthroplasty when the humeral head is severely fractured but the socket is normal. Other indications for a hemiarthroplasty include:

• Arthritis that involves only the head of the humerus, with a glenoid that has a healthy and intact cartilage surface
• Shoulders with severely weakened bone in the glenoid
• Some shoulders with severely torn rotator cuff tendons and arthritis

Sometimes, surgeons make the decision between a total shoulder replacement and a hemiarthroplasty in the operating room at the time of the surgery.

3. Resurfacing Hemiarthroplasty

Resurfacing hemiarthroplasty involves replacing just the joint surface of the humeral head with a cap-like prosthesis without a stem. With its bone-preserving advantage, it offers those with arthritis of the shoulder an alternative to the standard stemmed shoulder replacement.

Resurfacing hemiarthroplasty may be an option for you if:

• The glenoid still has an intact cartilage surface
• There is a desire to preserve humeral bone

4. Reverse Total Shoulder Replacement

Another type of shoulder replacement is called reverse total shoulder replacement. Reverse total shoulder replacement is used for people who have:

• Completely torn rotator cuffs with severe arm weakness
• The effects of severe arthritis and rotator cuff tearing (cuff tear arthropathy)
• Had a previous shoulder replacement that failed

Complications

When complications occur, most are successfully treatable. Possible complications include the following.

• Infection. Infection is a complication of any surgery.
• Prosthesis Problems. The components of a shoulder replacement may also dislocate. Excessive wear, loosening, or dislocation may require additional surgery (revision procedure).
• Nerve damage. Nerves in the vicinity of the joint replacement may be damaged during surgery, although this type of injury is infrequent. Over time, these nerve injuries often improve and may completely recover.

Recovery

You will most likely be able to go home on the first, second, or third day after surgery.

Your medical team will give you several doses of antibiotics to prevent infection. Most patients are able to eat solid food and get out of bed the day after surgery.

Pain Management

After surgery, you will feel some pain. This is a natural part of the healing process.

Medications are often prescribed for short-term pain relief after surgery

Pain management is an important part of your recovery. You will begin physical therapy soon after surgery, and when you feel less pain, you can start moving sooner and get your strength back more quickly

Rehabilitation

A careful, well-planned rehabilitation program is critical to the success of a shoulder replacement. You usually start gentle physical therapy soon after the operation. Ahome exercise program is undertaken to strengthen your shoulder and improve flexibility.

Your Recovery At Home

When you leave the hospital, your arm will be in a sling. You will need the sling to support and protect your shoulder for the first 2 to 6 weeks after surgery, depending on the complexity of your surgery and your surgeon's preference.

Wound care. You will have staples running along your wound or a suture beneath your skin. The staples will be removed several weeks after surgery. A dissolving suture beneath your skin will not require removal.

Avoid soaking the wound in water until it has thoroughly sealed and dried. You may continue to bandage the wound to prevent irritation from clothing.

Activity. Exercise is a critical component of home care, particularly during the first few weeks after surgery. Follow your surgeon's home exercise plan to help you regain strength. Most patients are able to perform simple activities such as eating, dressing, and grooming, within 2 weeks after surgery. Some pain with activity and at night is common for several weeks after surgery.

You are not allowed to drive a car for 2 to 6 weeks after surgery.

Do's and Don'ts

The success of your surgery will depend largely on how well you follow your orthopaedic surgeon's instructions at home during the first few weeks after surgery.

Here are some common do's and don'ts for when you return home:

• Don't use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.
• Do follow the program of home exercises prescribed for you. You may need to do the exercises 2 to 3 times a day for a month or more.
• Don't overdo it! If your shoulder pain was severe before the surgery, the experience of pain-free motion may lull you into thinking that you can do more than is prescribed. Early overuse of the shoulder may result in severe limitations in motion.
• Don't lift anything heavier than a glass of water for the first 2 to 4 weeks after surgery.
• Do ask for assistance. Your physician may be able to recommend an agency or facility to help if you do not have home support.
• Don't participate in contact sports or do any repetitive heavy lifting after your shoulder replacement.
• Do avoid placing your arm in any extreme position, such as straight out to the side or behind your body for the first 6 weeks after surgery.

Many thousands of patients have experienced an improved quality of life after shoulder joint replacement surgery. They experience less pain, improved motion and strength, and better function.

How long will shoulder replacement last?

It’s difficult to say just how long your shoulder replacement will last. Experts estimate that most modern shoulder replacements will last for at least 15 to 20 years.

Revision surgery for a shoulder replacement is rarely needed.