Note the decreased joint space arrow. Shoulder replacement surgery is highly technical. It should be performed by a surgical team with experience in this procedure. There are different types of shoulder replacements. Your surgeon will evaluate your situation carefully before making any decisions. He or she will discuss with you which type of replacement would best meet your health needs. Do not hesitate to ask what type of implant will be used in your situation, and why that choice is right for you. The typical total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket.
These components come in various sizes. They may be either cemented or "press fit" into the bone. If the bone is of good quality, your surgeon may choose to use a non-cemented press-fit humeral component. If the bone is soft, the humeral component may be implanted with bone cement. In most cases, an all-plastic glenoid socket component is implanted with bone cement. Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.
These x-rays were taken before and after total shoulder replacement surgery for osteoarthritis. Depending on the condition of your shoulder, your surgeon may replace only the ball. This procedure is called a hemiarthroplasty. In a traditional hemiarthroplasty, the head of the humerus is replaced with a metal ball and stem, similar to the component used in a total shoulder replacement.
This is called a stemmed hemiarthroplasty. Some surgeons recommend hemiarthroplasty when the humeral head is severely fractured but the socket is normal. Other indications for a hemiarthroplasty include:. Sometimes, surgeons make the decision between a total shoulder replacement and a hemiarthroplasty in the operating room at the time of the surgery. Studies show that patients with osteoarthritis get better pain relief from total shoulder arthroplasty than from 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. For patients who are young or very active, resurfacing hemiarthroplasty avoids the risks of component wear and loosening that may occur with conventional total shoulder replacements in this patient population. Due to its more conservative nature, resurfacing hemiarthroplasty may be easier to convert to total shoulder replacement, if necessary at a later time.
This x-ray shows the cap-like prosthesis used in resurfacing hemiarthroplasty. Another type of shoulder replacement is called reverse total shoulder replacement. Reverse total shoulder replacement is used for people who have:. For these individuals, a conventional total shoulder replacement can still leave them with pain. They may also be unable to lift their arm up past a degree angle. Not being able to lift one's arm away from the side can be severely debilitating.
In reverse total shoulder replacement, the socket and metal ball are switched. That means a metal ball is attached to the shoulder bone and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm. Your orthopaedic surgeon will explain the potential risks and complications of shoulder joint replacement, including those related to the surgery itself and those that can occur over time after your surgery. When complications occur, most are successfully treatable. Possible complications include the following.
Infection is a complication of any surgery. In shoulder joint replacement, infection may occur in the wound or deep around the prosthesis. It may happen while in the hospital or after you go home. It may even occur years later. Minor infections in the wound area are generally treated with antibiotics.
Major or deep infections may require more surgery and removal of the prosthesis. Although prosthesis designs and materials, as well as surgical techniques, continue to advance, the prosthesis may wear down and the components may loosen. The components of a shoulder replacement may also dislocate.
Excessive wear, loosening, or dislocation may require additional surgery revision procedure. 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.
Be sure to talk to your orthopaedic surgeon about the medications you take. Some medications may need to be stopped before surgery. For example, the following over-the-counter medicines may cause excessive bleeding and should be stopped 2 weeks before surgery:. If you take blood thinners, either your primary care doctor or cardiologist will advise you about stopping these medications before surgery.
For the first several weeks after your surgery, it will be hard to reach high shelves and cupboards. Before your surgery, be sure to go through your home and place any items you may need afterwards on low shelves. When you come home from the hospital, you will need help for a few weeks with some daily tasks like dressing, bathing, cooking, and laundry. If you will not have any support at home immediately after surgery, you may need a short stay in a rehabilitation facility until you become more independent.
Wear loose-fitting clothes and a button-front shirt when you go to the hospital for your surgery. After surgery, you will be wearing a sling and will have limited use of your arm.
Reverse Shoulder Replacement
You will most likely be admitted to the hospital on the day of your surgery. After admission, you will be taken to the preoperative preparation area and will meet a doctor from the anesthesia department. You, your anesthesiologist, and your surgeon will discuss the type of anesthesia to be used. You may be provided a general anesthetic you are asleep for the entire operation , a regional anesthetic you may be awake but have no feeling around the surgical area , or a combination of both types.
The procedure to replace your shoulder joint with an artificial device usually takes about 2 hours. After surgery, you will be moved to the recovery room, where you will remain for several hours while your recovery from anesthesia is monitored. After you wake up, you will be taken to your hospital room. 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.
You will most likely be able to go home on the first, second or third day after surgery. After surgery, you will feel some pain. This is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover from surgery faster.
Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs NSAIDs , and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids. Be aware that although opioids help relieve pain after surgery, they are a narcotic and can be addictive. Opioid dependency and overdose has become a critical public health issue in the U.
It is important to use opioids only as directed by your doctor. As soon as your pain begins to improve, stop taking opioids. Talk to your doctor if your pain has not begun to improve within a few days of your surgery. Pain management is an important part of your recovery. Physical therapy will begin soon after surgery, and when you feel less pain, you can start moving sooner and get your strength back more quickly. Talk with your doctor if postoperative pain becomes a problem. 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. Your surgeon or physical therapist will provide you with a home exercise program to strengthen your shoulder and improve flexibility. 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 4 weeks after surgery. 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 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. 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. 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. Sometimes the local anaesthetic from the operation wears off in the middle of the night. This can cause disturbed sleep and tiredness.
You'll probably be given painkillers before you go to sleep to make sure you'll be more comfortable. The drip and any drains are usually removed within 24 hours. After that you'll be able to start gently moving your arm again. You'll usually be in hospital for 2—3 nights after your surgery. During this time medical, nursing, physiotherapy and occupational therapy staff will be involved in your care. You'll be given drugs after the operation to keep your arm as free from pain as possible. These may include:. X-rays of your new joint will be taken during your stay in the hospital.
Your arm will be in a sling or splint to protect it. If a tube was placed in the wound during the operation to allow blood to drain out, it's normally removed after 1—2 days this isn't painful and is usually done on the ward. It's important during the first few days after your surgery that you keep your hand and forearm raised preferably above the level of your heart and exercise your fingers on a regular basis. These exercises are simple to do and include making a full fist and stretching your fingers.
If you had a shoulder replacement you'll be in a sling to support your shoulder. You may need to keep this on for up to 4 weeks but different surgeons have different procedures. After an elbow replacement, some surgeons use a plaster support called a slab behind the elbow to keep it in a fairly straight position for a few days. You won't be able to move your elbow in the slab, but once it's removed you can start moving your elbow again.
Frequently Asked Questions
Your physiotherapist will see you in hospital after the operation to help get you moving and advise you on exercises to strengthen your muscles. It's very important to follow this advice. Because there are several different types of shoulder and elbow surgery, there's no single aftercare programme. Your post-op therapy will differ depending on the procedure you've had and also between different units and surgeons, so we can't recommend specific exercise plans.
We suggest that you discuss with your surgeon what to expect after the operation. Most people are ready to leave hospital within 2—3 days. How soon you can go home depends on how well the wound is healing and whether you'll be able to get about safely. After about 2 weeks you'll need to attend the outpatient department for a routine check-up to make sure your recovery is going well and your wound is healed. You may also be offered outpatient physiotherapy if your doctors feel that this will help your recovery. If you stopped taking any of your regular medications or had to alter the dose before the operation, it's very important to talk to your rheumatologist or another healthcare professional for advice on when to start taking them again.
After elbow replacement surgery, you shouldn't lift objects heavier than a small bag of sugar for the rest of your life. The current artificial elbow joints aren't designed for any heavier work and the new joint probably won't last as long if you over-stress it. If you had both sides of your shoulder joint replaced total shoulder replacement , you should also avoid heavy loads to help your new joint last longer. This is especially important if you've had a reverse anatomy arthroplasty.
Some patients spend longer in rehab than others. Usually after 6 weeks the pain has subsided enough for you to lift your arm and perform daily activities such as dressing, feeding and washing yourself. It may take up to 3 months before you can return to work, depending on the type of work you do. Heavy manual activities aren't recommended at any time following shoulder or elbow replacements. This is because heavy activity can loosen the replaced parts in the bone and damage the artificial joint.
You'll be able to drive after your joint replacement as long as you can safely control the vehicle and do an emergency stop. It's important to check with your insurance company, and you need to be confident that you can control the vehicle at all times. As with any operation, a very small number of people may have problems after a shoulder or elbow joint replacement. Most of these problems are quite minor and can be treated easily.
The main problems include:. In most cases, infections can be cleared up with tablets or injections of antibiotics. For a more serious infection you may need another operation to treat the infection and replace the components. There's a very good chance that your shoulder or elbow replacement will last for 10 years. After this time it may loosen or wear out. A second joint replacement revision surgery may then be possible, although it's usually not so effective in easing symptoms. In a revision operation the original components will be removed, along with any cement that may have been used.
The shaft of the humerus will often have become thinner by the time revision surgery is needed, and because further bone is removed during the operation the humerus is more prone to fracture. If the original surgery was a shoulder resurfacing operation, revision surgery is usually a little easier because less bone will have been removed in the first operation.
- Do I need a shoulder and elbow replacement?;
- How can you care for yourself at home?.
- How To Get What You Want From Life: Practical Techniques For Building The Future Youve Always Wanted.
- Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review!
- Youve Come A Long Way, Baby: Women, Politics, and Popular Culture.
- Japanese Vocabulary - English/Japanese Flashcards - 4 books in 1 (Flashcard eBooks).
Shoulder replacement - Wikipedia
I respond best to clear, simple questions about one type of arthritis. For example, "What exercises should I do? If you need help from a real person here at Versus Arthritis, you can call our free helpline on Your conversation will not be visible the next time you visit the Arthritis Virtual Assistant. If you want to keep a copy of the advice you've been given, you can print it using the button at the top of the chat window.
If you would like to share any additional feedback with us, please email supportercare versusarthritis. The AVA provides general information. If you need more information or have any concerns, speak to a healthcare professional. Call us for free help and advice on your type of arthritis. Calls are recorded for quality purposes. Shoulder and Elbow Replacement Shoulder and elbow joint replacement information booklet 2.
Print This Page. Do I need a shoulder and elbow replacement? What are the possible advantages of shoulder and elbow replacement? The possible advantages and benefits of shoulder or elbow joint replacement include: reduced joint pain an improved range of joint movement in some cases improved quality of life. What are the possible disadvantages of shoulder and elbow replacement? A replacement joint can never be as good as a normally-functioning natural joint. What are the alternatives to shoulder or elbow joint replacement?
These include: non-steroidal anti-inflammatory drugs NSAIDs disease-modifying anti-rheumatic drugs DMARDs steroid injections injections of local anaesthetic to numb the nerves physiotherapy. Shoulder replacement The shoulder is a ball-and-socket joint. There are several types of shoulder replacement surgery: Hemiarthroplasty is where the ball part of the joint the humeral head is replaced with an artificial ball component with a stem that extends into the shaft part of the bone.
Elbow replacement In elbow replacements both sides of the joint are replaced. How should I prepare for shoulder or elbow replacement? Pre-admission clinic Most hospitals invite you to a pre-admission clinic, usually about 2—3 weeks before the surgery. This may involve the following tests: blood tests to check for anaemia and to make sure your kidneys are working properly x-rays of the affected body part a urine sample to rule out infection an electrocardiogram ECG scan to make sure your heart is healthy.
Going into hospital Before you go into hospital you should think about the following: Do you have someone to take you to the hospital and bring you home after the operation? Is everything set up at home ready for your return - is everything you need within easy reach? Do you have any special equipment ready for when you come home? Do you need someone to stay with you for a while after your operation?