joint. The "ball part of the joint is the top part of your upper arm bone. The "socket" part of your joint is a cup shaped indentation in your shoulder blade. A smooth tissue called cartilage lines the ends of the bones. This helps the joint glide easier. Four muscles called the rotator cuff surround the joint. They help with movement and stability. With normal wear and tear or other problems, the cartilage can wear down. Then, the joint can become damaged. This can lead to pain and loss of motion. Surgery may be done when PT and drugs for pain have not helped and the problem gets worse. In a shoulder replacement surgery, the ball or both the ball and the socket are replaced with man-made parts. ‚
There are 4 different types of shoulder replacement surgeries. You surgeon will decide what is the best option for you. ‚
- Both the ball and socket are replaced. This is a total shoulder replacement.
- Just the ball is replaced. This is a stemmed hemiarthoplasty.
- A cap is placed over the current ball in the shoulder. This is a resurfacing arthroplasty.
- A socket is made on the arm bone and a ball is put at the end of the shoulder blade. This is a reverse total shoulder replacement.
Replacing the shoulder may help you have better range of motion. You may be able to get more arm strength and be able to go back to your everyday activities. ‚
A shoulder replacement may be done to fix damage from: ‚
- Wear and tear arthritis. This is osteoarthritis.
- Inflammatory arthritis. This is rheumatoid arthritis.
- Shoulder injury like a brake, rotator cuff injury
- Loss of blood supply to the ball of the shoulder. This is avascular necrosis.
- Previous surgery that did not work
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What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- X-rays
- Ultrasound
- CT or MRI scan
- Electrocardiogram (ECG)
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
- When you are asleep, the doctors will put a tube in your mouth to help you breathe. You will have a tube in your bladder to drain urine.
- Monitors will keep track of your blood pressure and heart rate. Your shoulder will be cleaned with an antiseptic.
- Your doctor will make a cut on the front of your shoulder. Your doctor will then pull back the rotator cuff muscles and open up the area to see the joint.
- Your doctor will remove any damaged bone and put in any new shoulder parts. Your doctor will put the muscles back. The doctor will close the cut with staples or stitches and cover it with bandages.
- The procedure takes about 2 hours.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. Your doctor may give you drugs for pain.
- Your doctor may have put a rubber tube in to help drain urine. Your doctor may have you keep this in for up to 24 hours.
- Your doctor may have you use a continuous passive motion machine after surgery. This keeps the shoulder moving to lessen pain and prevent stiffness and scar tissue from forming.
- Nurses will put ice packs on your shoulder to help lessen pain and swelling.
- You will need to wear a sling to support your shoulder for the next 2 to 6 weeks. Ask your doctor how long you need to wear the sling.
- You will begin physical therapy (PT) on the same day of or the day after your surgery. You will learn exercises to do every day.
- You may have to stay in the hospital for 1 to 2 days.
What lifestyle changes are needed?
- Your doctor will give you a card that lets people know that you have metal hardware inside your shoulder. Bring this card with you always, especially when you go to airports and buildings with metal detectors.
- Avoid or use caution when playing sports that will put a lot of strain on your shoulder like throwing sports and tennis.
- After going through a rehab program, your doctor may suggest that you keep doing activities that will strengthen your shoulder.
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain and swelling
- Prevent infection
What problems could happen?
- Infection
- Bleeding
- Ongoing pain and stiffness
- Nerve or blood vessel injury
- Hardware failure or loosening of hardware
- Allergic reaction to metal plates and screws
What can be done to prevent this health problem?
Stay active and work out to keep your muscles strong and flexible. ‚
Where can I learn more?
American Academy of Orthopaedic Surgeons ‚
http://orthoinfo.aaos.org/topic.cfm?topic=A00094 ‚
http://orthoinfo.aaos.org/topic.cfm?topic=A00504 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚