What is shoulder replacement surgery?

What is shoulder replacement surgery?

‍

Shoulder replacement surgery, also known as shoulder arthroplasty, is a surgical procedure to replace the damaged or diseased parts of the shoulder joint with artificial components. It is typically performed to relieve severe pain and improve joint function in individuals with advanced shoulder joint arthritis or other conditions that cause significant joint deterioration.

‍

The shoulder joint is a ball-and-socket joint, where the upper arm bone (humerus) fits into the shallow socket of the shoulder blade (scapula). In shoulder replacement surgery, the damaged or worn-out parts of the joint are replaced with prosthetic components, which can be made of metal, plastic, or ceramic materials. The two most common types of shoulder replacement procedures are:

‍

1. Total Shoulder Replacement (Total Shoulder Arthroplasty): In total shoulder replacement, both the ball of the humerus and the socket of the scapula are replaced with artificial components. The prosthetic ball is attached to the top of the humerus, and the prosthetic socket is fixed to the glenoid (the socket of the scapula). This type of surgery is suitable for individuals with widespread arthritis and significant joint damage.
2. Reverse Total Shoulder Replacement (Reverse Total Shoulder Arthroplasty): In this procedure, the positions of the prosthetic components are reversed. The prosthetic ball is fixed to the glenoid, and the prosthetic socket is attached to the top of the humerus. This type of surgery is often recommended for individuals with severe rotator cuff tears or other conditions that affect the rotator cuff muscles, making a traditional total shoulder replacement less effective.

‍

Shoulder replacement surgery aims to reduce pain, improve shoulder joint function, and restore or improve strength and functional use of the upper extremity. It is typically considered when conservative treatments such as medications, physical therapy, and lifestyle modifications no longer provide sufficient relief for the pain and disability caused by shoulder joint arthritis or other joint conditions.

‍

Who can benefit from shoulder replacement surgery?

‍

Shoulder replacement surgery can benefit individuals who experience persistent severe shoulder pain, loss of shoulder mobility or stability and upper extremity strength leading to inability to perform functional tasks with the involved upper extremity, due to various shoulder joint conditions that are listed below. 

‍

1. Osteoarthritis: Shoulder osteoarthritis is a chronic degenerative joint disease that causes the cartilage in the shoulder joint to wear away, leading to pain, stiffness, and reduced mobility.
2. Rheumatoid Arthritis: Rheumatoid arthritis is an autoimmune, chronic, inflammatory, systemic disease that causes inflammation and joint damage, including the shoulder joint.
3. Post-Traumatic Arthritis: This type of arthritis can develop after a severe shoulder injury or fracture, leading to long-term joint damage and pain.
4. Avascular Necrosis (Osteonecrosis): Avascular necrosis occurs when the blood supply to the bone in the shoulder joint is disrupted, leading to bone death and joint deterioration.
5. Rotator Cuff Tear Arthropathy: This condition is characterized by a severe rotator cuff tear that results in progressive arthritis and weakness in the shoulder.
6. Severe Fractures: Severe fractures of the humerus or glenoid can lead to significant joint damage, making shoulder replacement surgery necessary.
7. Failed Previous Surgeries: In some cases, individuals may have undergone prior shoulder surgeries that were unsuccessful or led to complications, necessitating shoulder replacement.
8. Chronic Shoulder Pain: Individuals with chronic shoulder pain that significantly affects their daily activities and quality of life may benefit from shoulder replacement surgery.

‍

It's essential to note that shoulder replacement surgery is usually considered after other non-surgical treatments have been exhausted or have proven ineffective in providing pain relief and improving shoulder function. The decision to undergo shoulder replacement surgery is made on an individual basis after a thorough evaluation by an orthopedic surgeon.

‍

Candidates for shoulder replacement surgery are typically evaluated based on factors such as their overall health, medical history, age, activity level, and the severity of their shoulder condition. Before considering surgery, patients are usually encouraged to try conservative treatments and engage in physical therapy to strengthen the shoulder and improve range of motion. The decision to undergo shoulder replacement surgery should be made in consultation with an experienced orthopedic surgeon who can assess the individual's specific condition and recommend the most appropriate treatment plan for optimal outcomes.

‍

After shoulder replacement surgery: What to expect

‍

After shoulder replacement surgery, the recovery process is essential to ensure proper healing and optimal shoulder function. Here's what you can generally expect after undergoing shoulder replacement surgery:

‍

1. Hospital Stay: Most patients stay in the hospital for one to three days following the surgery. The length of the hospital stay may vary depending on the type of surgery performed and the individual's overall health.
2. Pain Management: You may experience pain and discomfort after the surgery. Your healthcare team will provide pain medications to manage post-operative pain.
3. Immobilization: Your shoulder may be immobilized using a sling or a shoulder immobilizer to protect the surgical site and allow for initial healing. The duration of immobilization will depend on your surgeon's recommendation.
4. Physical Therapy: Physical therapy will play a crucial role in your recovery. You will likely start physical therapy exercises in the hospital to promote shoulder movement and prevent stiffness. It will also be continued after you leave the hospital to help you regain your shoulder strength, flexibility and function. Your therapist will tailor the exercises to your specific needs and the type of surgery you had.
5. Home Care Instructions: You will receive specific home care instructions on wound care, medications, and activity restrictions from your healthcare team.
6. Dressing Changes: You may need to change dressings on the incision site as directed by your healthcare provider to keep the area clean and prevent infection.
7. Gradual Progression: As you heal, you will gradually increase the range of motion and weight-bearing on the affected shoulder under the guidance of your physical therapist.
8. Follow-up Appointments: You will have regular follow-up appointments with your surgeon to monitor your progress and address any concerns.
9. Return to Daily Activities: The timeline for returning to daily activities, including work and recreational activities, will vary based on your recovery and the type of shoulder replacement surgery you underwent.
10. Driving Restrictions: Driving restrictions may apply after the surgery, and your surgeon will provide guidance on when it is safe to resume driving.

‍

It's essential to follow your surgeon's and physical therapist's instructions diligently to ensure a successful recovery. Full recovery after shoulder replacement surgery can take several months, and patience and commitment to the rehabilitation process are crucial for achieving the best possible outcomes. Your healthcare team will guide you throughout the recovery process, addressing any concerns and ensuring your safety and well-being.

‍

How can physical therapy help? 

‍

Physical therapy plays a crucial role in the recovery process after shoulder replacement surgery. A physical therapist can design a customized rehabilitation program to help you regain shoulder strength, mobility, and function while ensuring a safe and successful recovery. Here's how physical therapy can help with shoulder replacement surgery:

‍

1. Pain Management: Physical therapists use various modalities and techniques to manage post-operative pain, such as ice, heat, ultrasound, electrical stimulation, and manual therapy. Prescribed analgesic and anti-inflammatory medications will also be utilized to control pain and inflammation.
2. Range of Motion Exercises: Early after surgery, physical therapists usually prescribe passive or active range of motion exercises with or without assistance to maintain range of motion and minimize muscle spasm. As the patient improves, stretching exercises and joint mobilization techniques are utilized to increase muscle flexibility and range of motion of the affected shoulder. 
3. Strengthening Exercises: As healing progresses, physical therapists prescribe targeted strengthening exercises to restore and improve muscle strength of the affected shoulder.  Initially, pain-free, low-intensity resisted isometrics (contraction) of shoulder muscles and tendons are prescribed, as well as dynamic resistance exercises for the scapula and shoulder musculature with the use of light weights or light-grade elastic resistance. As the patient tolerates, the therapist will progress the program to a pain-free, low-load, high repetition progressive resistive exercise of the shoulder. These exercises will also help the patient to improve muscular endurance and performance.
4. Stabilization Exercises: Physical therapists will prescribe scapular and shoulder joint stabilization exercises, progressing from a non-weight bearing to light weight bearing positions to develop shoulder dynamic stability.
5. Scar Tissue Management: Physical therapists can use manual techniques such as, friction massage, and stretching to minimize scar tissue adhesions and improve tissue mobility.
6. Activity Modification: Physical therapists will provide modification techniques for a high-demand, high-impact work related or recreational activities to avoid imposing excessive forces on the shoulder joint that could lead to loosening or premature wear of prosthetic implants. 
7. Functional Training: As the shoulder muscle strength, endurance, performance and joint stability improve, functional training is prescribed. It simulates the physical demands of a patient’s work or desired recreational or sport activity. Simulated activities and drills enable a patient to practice under supervised conditions to receive feedback on correct mechanics. 
8. Education: Physical therapists educate the patients about shoulder replacement surgery, its indications and benefits as well as the role and importance of postoperative rehabilitation. They also teach postoperative precautions and proper shoulder care for optimal recovery. 
9. Home Exercise Program: Your physical therapist will provide you with a specialized home exercise program and teach how to safely incorporate it into your daily routine to reinforce the interventions and ensure long-term recovery.
10. Gradual Return to Activities: Physical therapists guide you in gradually returning to activities, sports, and work while ensuring the shoulder is adequately prepared for the demands of each task.

‍

Each patient's recovery is unique, and physical therapists tailor the treatment plan based on the specific type of shoulder replacement surgery and individual needs.

‍

By working closely with a physical therapist, you can optimize your recovery after shoulder replacement surgery and achieve improved shoulder function. The therapist's expertise and guidance ensure a safe and effective rehabilitation process, helping you to relieve pain, improve shoulder mobility and stability, regain strength and functional use of the upper extremity. 

Trust PeteHealth for recovery from shoulder replacement surgery

Looking for a physical therapist to help you recover from shoulder replacement surgery? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

‍

Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

‍