What to Expect After Shoulder Replacement Surgery Dr. Rahman Kandil


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Shoulder replacement surgery replaces a worn, painful shoulder joint with a new, functional joint made from metal and plastic. According to the American Association of Orthopaedic Surgeons (AAOS), about 53,000 shoulder replacements are performed in the United States each year.


Reasons for Shoulder Replacement Surgery

Total shoulder replacement is done when medications and changes to physical activity fail to relieve debilitating shoulder joint pain. This pain usually is caused by a shoulder condition or injury that interferes with daily life. These conditions and injuries include:

  • Severe shoulder fractures or other serious shoulder injuries
  • Osteoarthritis
  • Rheumatoid arthritis
  • Avascular necrosis
  • Rotator cuff injury resulting in joint arthritis

What to Expect From Shoulder Replacement Surgery

Before surgery, you may meet with your doctor for a physical exam, medical history, and tests. These may include blood tests and imaging studies that help evaluate the shoulder joint and surrounding structures, such as:

  • X-rays
  • CT scan
  • MRI scan

Talk to your doctor about your medications. You may be asked to stop taking some medications up to 2 weeks before the procedure, especially:

  • Non-steroidal anti-inflammatory medications like aspirin, ibuprofen, and naproxen sodium
  • Most arthritis medications

In addition, in the weeks following surgery it may be difficult to reach high shelves. Before your procedure, it is a good idea to put any items that you use often in an easy to reach location. Driving is not allowed for 2 to 4 weeks after surgery, so be sure to arrange for rides from friends and family.


Anesthesia

You will receive anesthesia to prevent any pain during surgery. Types of anesthesia include:

  • General anesthesia—you will be asleep through the surgery
  • Regional anesthesia—blocks pain in the upper body, but you will not be asleep

Description of Shoulder Replacement Surgery

The surgeon will make a cut through your skin near your shoulder. The large muscles around the shoulder will be pulled back and another incision will be made in the rotator cuff. The rotator cuff is made of tendons that cover and support the shoulder joint. Pulling back the muscles and tendons allows the doctor to have a clear view of the shoulder joint.

The surgeon then removes the shoulder joint and replaces all or part of it with an artificial implant that includes a ball, socket, and stem parts. After inserting the implant, the doctor will close the incision in the rotator cuff, muscles, and skin with stitches. A drain may also be inserted to remove fluids that may build up in the shoulder after surgery.

Shoulder replacement surgery typically takes a few hours. It is performed in a hospital and the average length of stay is about 2 to 3 days. If you have any complications, your stay may be longer.


Post-surgery Care At the Hospital

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Any pain and discomfort can be managed with medications. Recovery also may include:

  • Antibiotics to prevent infection
  • Medication to prevent blood clots
  • X-rays to evaluate the new shoulder joint

You may start gentle physical therapy as early as the day after your surgery. A physical therapist will work with you to help you regain your range of motion and strength in your shoulder.


Post-surgery Care At Home

The hospital staff will teach you how to care for your dressings or bandages to help prevent wound infection. You also will wear an arm sling for the first 2 to 4 weeks after surgery to help support your shoulder as it heals. You should be able to do simple tasks by yourself, like eating and dressing, within 2 weeks after surgery. In the meantime, family members or friends may need to help you with daily activities like bathing, cooking, and doing laundry. If you will not have support at home post-surgery, you may need a short stay in a rehabilitation facility until you can perform those tasks on your own again.

Continuing physical therapy at home is crucial to ensuring a successful recovery and regaining strength and flexibility in your shoulder joint.

Note: Now that you have an artificial joint, you may need antibiotics before certain dental procedures or surgeries. This will prevent possible infections from entering the bloodstream. Make sure to let your dentist or doctor know that you have an artificial joint.

AAOS recommends the following dos and don'ts after you return home:

  • Don't use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.
  • Do follow the program of home exercises prescribed for you. You may need to do the exercises 2 to 3 times a day for a month or more.
  • Don't overdo it! If your shoulder pain was severe before the surgery, the experience of pain-free motion may lull you into thinking that you can do more than is prescribed. Early overuse of the shoulder may result in severe limitations in motion.
  • Don't lift anything heavier than a glass of water for the first 2 to 4 weeks after surgery.
  • Do ask for assistance. Your physician may be able to recommend an agency or facility if you do not have home support.
  • Don't participate in contact sports or do any repetitive heavy lifting after your shoulder replacement.
  • Do avoid placing your arm in any extreme position, such as straight out to the side or behind your body for the first 6 weeks after surgery.

Complications of Shoulder Replacement Surgery

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential issues, like:

  • Chronic shoulder pain and stiffness
  • Shoulder instability
  • Infection
  • Nerve damage
  • Loose shoulder joint

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic diseases like diabetes or obesity

When to Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. If any of the following occur, alert your doctor right away:

  • Shoulder stiffness, pain, or instability
  • Problems at the incision site, such as bleeding or drainage
  • Signs of an infections such as fevers, chills, redness, or warmth
  • Numbness or tingling in your shoulder, arm, or fingers

If you think you have an emergency, call 911 right away.


If you would like to make an appointment with Dr. Rahman Kandil to discuss shoulder replacement surgery or other joint-related issues, go to Dr. Kandil's physician page or call (703) 665-2720 and we will be happy to assist you.

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