Total Shoulder Replacement
Who does it affect?
People suffering with Arthritis of the shoulder joint.
Why is this used?
A total shoulder replacement has a metal stem which is put down the inside of the humerus. A new, usually plastic, socket is also inserted. This is used if a Surface shoulder replacement is not appropriate for your shoulder.
- Pain and stiffness of the shoulder.
It is usual for an x-ray to be carried out. Occasionally, a CT scan is also required.
These x-rays were taken before and after total shoulder replacement surgery for osteoarthritis
Physiotherapy may be used to minimise any inflammation present, strengthen the shoulder muscles and try to improve the movement in the shoulder.
Therapeutic steroid injections may be used to reduce inflammation and provide pain relief. These are only performed once or twice and may be done via ultrasound guidance.
Pain-killers and anti-inflammatory drugs will also be offered. Often pain and weakness is not improved with physiotherapy or injections and at this time you will be offered surgery.
Surgery is carried out under general anaesthetic and takes about 60 minutes.
You will need to stay in hospital 1-2 days. You will return from theatre wearing a sling. The sling is worn for four weeks.
The anaesthetic will wear off after approximately 6 hours. Simple analgesia (pain killers) usually controls the pain and should be started before the anaesthetic has worn off. The dressing will be removed after 2 days. The wound is cleaned and redressed with a simple dressing. Avoid lifting heavy objects for 2-3 weeks. The sutures are trimmed at about 12 days.
Return to normal routine
Keep the wound dry until the stitches are out at 10 days.
Return to driving:
You are advised to avoid driving until full movement of the shoulder has returned. You will be given further advice about this by me or your physiotherapist.
Return to work:
Everyone has different work environments. Returning to heavy manual labour should be prevented for approximately 4 - 6 weeks. Early return to heavy work may cause the tendons and nerve to scar into the released ligament. You will be given advice on your own particular situation.
Overall over 97% are happy with the result. However complications can occur.
General risks (less than 1% each):
- Neuroma (nerve pain)
Reflex Sympathetic Dystrophy - RSD (<1% people suffer a reaction to surgery with painful stiff hands, which can occur with any upper limb surgery from a minor procedure to a complex reconstruction).
- Failure to completely resolve the symptoms
- Loosening of the implant
- Wear of the implant
- Fracture around the implant
- Thrombo-embolic problems.