Shoulder Replacement

Xray showing arthritis of the left shoulder

Xray showing a normal left shoulder joint

A shoulder replacement is for patients who have severe pain and stiffness in the shoulder joint.

You may benefit from shoulder replacement surgery if:

• Your shoulder pain is severe
• The pain is present at night and at rest
• It limits your ability to look after yourself
• You have tried non-surgical alternatives without success

Alternatives to surgery

Surgery may be necessary if your symptoms are severe. There are however some alternatives to surgery that may help with the symptoms. These include:

• Pain killers – such as paracetamol
• Anti-inflammatories – these medications can be harmful if used long-term and you should discuss the use of these medications with your GP before starting
• Physiotherapy – exercises to improve muscle strength may help with mobility and reduce pain
• Joint corticosteroid injections – shoulder joint injections with corticosteroids such as cortisone can provide pain relief. However, the effects are often temporary relief and there is a chance of introducing infection into the shoulder joint

Benefits of a shoulder replacement

A shoulder joint replacement is usually a very successful operation and will help to:

• Reduce pain
• Improve mobility. You should be able to move your shoulder joint more freely after your shoulder operation
• Improve your quality of life: With less pain and better mobility, you will be able to carry out your daily tasks more easily

Complications and Risks

Like all surgery, risks need to be considered when deciding to have shoulder replacement surgery.

Side effects

Side effects are symptoms that occur after every operation and are a normal part of the recovery from the operation. The main side effects of shoulder replacement surgery are:

• A sore shoulder which may last for several weeks after the operation
• Swelling in the shoulder which will also last for several weeks after the operation

Complications

Complications are uncommon problems that occur during or after the operation. Most people having shoulder surgery aren’t affected.

The general complications for all operations are:

• A reaction to the anaesthetic
• Infection of the wound or joint
• Excessive blood loss

Specific complications of shoulder replacement surgery are:

• Infection: This is a potential complication of any surgery. Infection may occur around the wound site, which is treated with antibiotics. It may also occur in the deeper tissues such as the shoulder joint which is a serious complication and may require more surgery.
• Fractures: A fracture is a break in the bone. Fractures can occur during a shoulder replacement while the new shoulder is being put in place.
• Damage to nerves – Nerves involving sensation and movement in the shoulder and arm may be damaged during surgery. This complication is uncommon, and nerves may recover if damaged. 
• Damage to blood vessels – Veins supplying the arm may be damaged during the procedure. Again, this is an uncommon complication. 
• Stiffness of the shoulder 
• Revision – More surgery may be required in the replaced shoulder. This may be due to loosening of implants, wearing down of joint surfaces, or dislocation of the joint. 

It is important to note that the risks of certain complications may be higher or lower if the person having the operation has a medical condition that makes them more vulnerable to risks. For example, we know that obesity significantly increases the risk of an infection after a shoulder replacement.

Before the operation

Preadmission Clinic | Preparing for Surgery

Before your operation, you will be seen at the Preadmission clinic to make sure you are fit for the operation and all the necessary tests are performed in preparation for the operation.

During the visit, you will be seen by a

• doctor
• nurse
• anaesthetist (if necessary)

Tests

Tests that may be ordered for you include:

• Shoulder x-ray
• Shoulder ultrasound
• Shoulder MRI
• blood tests
• Xray of your Chest
• Urine Test
• ECG

Preparing Your Skin

Your skin should not have any infections or irritations before surgery. If either is present, contact your orthopaedic surgeon for a program to improve your skin before surgery.

Tip

Carry a list of your medications with you including the name, dosage and how often you take it.

Medications

Our doctors will advise you which medications you should stop or can continue taking before surgery

About the Operation

The procedure to remove your shoulder joint with a prosthetic one takes approximately two hours.

After the Operation

After the operation, you are cared for in the Theatre Recovery room. You will usually only spend 1-2 hours in the recovery room. Most people wake up fully when back in their rooms on the ward. 

Whilst on the ward, the nurses will take care of your every need. It usually takes a few hours to recover fully from the anaesthetic, and the nurse with regularly check on your recovery. 

You will likely need to be in hospital for between 1-2 days. During this time you will receive antibiotics and pain relief (see Post-Operative Analgesia).

Recovery and Rehabilitation 

Recovery 

Avoid soaking the wound in water until it has completely dried. If there is any redness or pus around the wound, it is important to call your doctor immediately. 

Most people can do simple daily tasks at home within 2 weeks of the operation. Driving a car is not recommended for 2-4 weeks after surgery. 

Rehabilitation 

You will be required to wear a sling for 6 weeks. During this time, you will be given passive and active range of motion exercises to perform. After the initial 6-week period, you will be given strengthening exercises to do on top of this.

What can you expect to do after recovering from a shoulder joint replacement?

After healing from the surgery and completing rehabilitation, you can expect to use your shoulder for:

• Looking after yourself
• Simple daily tasks
• Driving
• Walking
• Running