Shoulder replacement surgery is usually performed on those suffering from debilitating shoulder arthritis, which is essentially the complete wearing out of the shoulder’s ball-and-socket and protective cartilage covering. However, certain injuries, like a torn rotator cuff, shoulder fracture or dislocated shoulder, can also require shoulder replacement surgery as late-stage treatment.
Shoulder arthritis most commonly develops due to overuse over time, trauma and/or genetics. The various forms of shoulder arthritis cause gradually chronic, persistent pain and decreased range of motion – both of which can worsen with continued activity.
Fortunately, therapy and surgery can help reduce pain and help maintain your range of motion. Explore your options for managing shoulder arthritis – whether that be non-invasive techniques or surgical treatment.
What is total shoulder replacement surgery?
In shoulder replacement surgery, a new shoulder joint is designed by placing a metal ball with a stem onto the shoulder. Next, the humerus is reattached to the new ball joint, which offers speedier recovery, better mobility, and improved function.
According to the Hospital for Special Surgery, some 95% of shoulder replacement patients regained full mobility––all after just a year of recovery time. While the stage of arthritis or severity of injury will result in varying healing times, shoulder replacement surgery is known as a highly effective treatment for end-stage arthritis or shoulder traumas that didn’t respond to conservative treatment.
How do I know if I need shoulder replacement surgery?
If you sustained trauma or injury to your shoulder in a fall or accident, you should seek treatment for these injuries immediately, because a fully torn tendon won't reattach itself to the bone on its own. Instead, it can pull further away and scar, making it harder to repair. Larger tear sizes may also require immediate surgery.
When it comes to treating pain associated with advanced arthritis, doctors and physical therapists will likely inform you of your surgical procedure options if your symptoms aren’t improving with more conservative treatment. Although shoulder replacement surgery helps in cases of severe degeneration, arthritic shoulder pain can be managed without replacement surgery.
According to Dr. Vladimir Alexander, Founder of Alexander Orthopaedics, “The shoulder is a very unstable joint by nature. In general, it is something that really needs a lot of stabilization.” Dr. Alexander recommends starting off with conservative treatments, but recommends learning exercises from physical therapists to ensure joint mobility and longevity.
Your treatment options will depend on the severity of your arthritis, level of current trauma, and any previously obtained injuries. Advanced arthritis can result in chronic pain, decreased mobilization, frozen shoulder and even tears or bone spurs. Shoulder replacements restore mobility and remove scar tissue and bone spurs.
Yet, research shows that waiting longer than 12 months for shoulder surgery may increase the chances of needing future procedures, called revision surgeries. If you have shoulder pain, it’s best to get it looked at quickly and if surgery is needed, to schedule a routine repair as soon as possible.
What are my shoulder arthritis treatment options?
These range from nonsurgical methods, such as limiting activity to surgical procedures, like total shoulder replacement. Tears rarely fully heal on their own, but therapy can help you retain a range of motion and shoulder function for less severe cases. Conservative measures are often used to treat recent shoulder injuries and the early stages of arthritis.
However, if your shoulder doesn't respond to non-invasive therapies or if severe shoulder arthritis pain persists, surgery may be necessary. For surgical repairs, your physician will discuss your options based on a number of factors.
Non-surgical Treatments for Shoulder Arthritis & Chronic Pain
Not all cases of shoulder arthritis require surgery. If the amount of damage to the shoulder tendon and protective cartilage is manageable, then nonsurgical treatments could help relieve pain, reduce inflammation, and improve mobility. In most cases, healthcare providers recommend a combination of several nonsurgical treatments. Together, they can strengthen the muscle and restore mobility. Some non-invasive treatments include:
- Anti-Inflammatories: Nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen can reduce swelling and relieve the pain.
- Activity modification: Refrain from activities or movements that aggravate the injury, and use an arm sling. This also may require positioning pillows during sleeping to avoid rolling over onto the damaged shoulder.
- Steroid injections: Corticosteroid shots can help limit acute inflammation and improve symptoms caused by bursitis, tendonitis, and small tears in the tendons.
- Physical therapy: While cortisone shots ease the swelling, occupational therapy will help prevent reinjury. PT will include working with a trained physical therapist to slowly increase your range of motion, along with exercises to perform at home.
The Two Types of Shoulder Replacement Surgeries
While it’s best to seek treatment in the early stages of arthritis, we know that this isn’t always the case for many different reasons. Symptoms can worsen with continued use and lack of treatment, resulting in tears, frozen shoulder and complete immobilization of the shoulder, which would then require surgery.
The type of shoulder repair surgery depends on your severity of arthritic deterioration or trauma. You can read about them below:
Total Shoulder Replacement Surgery
Shoulder replacement surgery involves replacing sections of the shoulder joint with artificial implants. The technique reduces pain and restores function and range of motion. Total shoulder replacement surgery is an outpatient procedure, and patients are often released soon after surgery.
Reverse Total Shoulder Replacement Surgery
Reverse shoulder replacement surgery is performed in someone with arthritis of the shoulder and a deficient rotator cuff. It involves replacing the damaged ball-and-socket with reversed components from a primary total shoulder replacement. This allows the patient to regain range of motion of the shoulder with a deficient rotator cuff. This surgery becomes necessary when the degeneration of the shoulder has become severe, due to arthritis or injury.
Are shoulder replacement procedures considered major surgery?
The technological breakthroughs in surgical procedures have broadened the types of rotator cuff injuries arthroscopy can repair. As a result, most shoulder replacement surgeries can be performed same-day as an outpatient procedure, meaning there are no overnight stays in the hospital.
How long does it take to recover from shoulder replacement surgery?
Recovery time varies depending on the stage of arthritic deterioration or injury's extent and the type of procedure performed. On average, it takes four to six months for a shoulder to heal post-replacement surgery. In most cases, regaining full range of motion can take a year or longer. For the first four to six weeks, expect to wear an arm sling to limit shoulder movement.
During the rehabilitation period, you can’t use your arm for anything besides limited movements like writing or taking a drink. Your doctor may suggest avoiding any shoulder movement and only move your wrist or elbow for these actions. Furthermore, some patients may be restricted from overhead lifting for up to a year after surgery.
Physical therapy sessions usually follow surgery to help you regain the strength and motion in your shoulder. Most patients spend several months rehabilitating after shoulder surgery and must dedicate time to occupational therapy sessions while completing strengthening exercises at home.
What is recovery like after shoulder replacement surgery?
After shoulder replacement surgery, you’ll likely feel pain and discomfort. In most cases, patients experience swelling in the shoulder, hand, or arms. There also may be some bruising near the incision site. Some patients report stomach problems or other surgery-related issues, as well.
Pain is a significant concern to most patients following surgery. The anesthetic and nerve block used during surgery will help alleviate the pain the day of the procedure, but having a plan in place once you get home will save you from suffering later.
Here are some tips to help you stay comfortable post-op:
- Ice pack: Putting an ice pack on your shoulder for 20-minutes at a time will help reduce inflammation and relieve pain. Place a towel around the ice pack to keep your incision dry.
- Medications: Talk to your doctor about what medications and techniques are best for managing pain. They might prescribe a pain reliever or recommend over-the-counter medications. Develop a pain management plan with your physician before surgery.
- Rest: Sleep is crucial to a successful recovery, but resting after rotator cuff repair can be difficult. It can take up to six weeks after surgery to sleep comfortably. Propping yourself up or sleeping in a recliner might be easier for a few weeks.
Potential Shoulder Replacement Surgery Complications
All surgical procedures come with the risk of complications. Although many of the outcomes are rare, knowing all possible complications before scheduling a treatment will keep you prepared. The potential complications from shoulder replacement surgery include:
- Infection: Signs of infection include swelling, redness, or drainage at the incision site.
- Damage to the Rotator cuff: One of the most common complications of shoulder surgery is a stiff shoulder.
- Replacement component loosening or dislocating: Although rotator cuff surgery has a high success rate, it's not 100% and some people don’t regain full function or require revision surgery.
- Nerve injury: Many nerves surround the shoulder joint, which lends a possibility for nerve damage.
- Reinjury: While shoulder surgery can be successful, there is a risk of damaging the injured tendon again.
- Anesthesia: There's a slight risk of heart attack, blood clots, and stroke when using anesthesia.
Shoulder Replacement Surgery at Alexander Orthopaedics
With surgical advancements, an outpatient shoulder replacement surgery can help improve your quality of life and help you avoid a long hospital stay. Our outpatient orthopedic surgery centers and expert surgeons provide the care you need before, during, and after surgery. Get on the road to recovery by connecting with Alexander Orthopaedics today.