Shoulder Replacement – Indications, Procedure, Risk

Total shoulder arthroplasty; Endoprosthetic shoulder replacement; Partial shoulder replacement; Partial shoulder arthroplasty; Replacement – shoulder; Arthroplasty – shoulder

Shoulder replacement is surgery to replace the bones of the shoulder joint with artificial joint parts.

Description

You will receive anesthesia before this surgery. Two types of anesthesia can be used:

• General anesthesia, which means you will be unconscious and unable to feel pain?.
• Regional anesthesia to numb your arm and shoulder area so that you do not feel any pain? in this area. If you receive regional anesthesia, you will also be given medicine to help you relax during the operation.

The shoulder is a ball and socket joint. The round end of the arm bone fits into the opening at the end of the shoulder blade, called the socket. This type of joint allows you to move your arm in most directions.

For total shoulder replacement, the round end of your arm bone will be replaced with an artificial stem that has a rounded metal head. The socket part (glenoid) of your shoulder blade will be replaced with a smooth plastic shell (lining) that will be held in place with a special cement. If only 1 of these 2 bones needs to be replaced, the surgery is called a partial shoulder replacement, or a hemiarthroplasty.

For shoulder joint replacement, your surgeon will make an incision (cut) over your shoulder joint to open up the area. Then your surgeon will:

• Remove the head (top) of your upper arm bone (humerus)
• Cement the new metal head and stem into place
• Smooth the surface of the old socket and cement the new one in place
• Close your incision with staples or sutures
• Place a dressing (bandage) over your wound

Your surgeon may place a tube in this area to drain fluid that may build up in the joint. The drain will be removed when you no longer need it.

This surgery usually takes 1 to 3 hours.

Why the Procedure Is Performed

Shoulder replacement surgery is usually done when you have severe pain? in the shoulder area, which limits your ability to move your arm. Causes of shoulder pain include:

• pain? and stiffness?. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।" data-rx-term="osteoarthritis" data-rx-definition="Osteoarthritis is wear-and-tear joint disease causing pain and stiffness. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।">Osteoarthritis?
• The poor result from a previous shoulder surgery
• pain?, swelling?, stiffness?, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">arthritis?: Rheumatoid arthritis is an autoimmune? joint disease causing infection?, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation?, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।" data-rx-term="rheumatoid arthritis" data-rx-definition="Rheumatoid arthritis is an autoimmune joint disease causing inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।">Rheumatoid arthritis?
• A badly broken bone in the arm near the shoulder
• Badly damaged or torn tissues in the shoulder
• Tumor in or around the shoulder

Your doctor may not recommend this surgery if you have:

• History of infection?, which can spread to the replaced joint
• Severe mental dysfunction
• Unhealthy skin around the shoulder area
• Very weak (rotator cuff) muscles around the shoulder that cannot be fixed during surgery

Risks

Risks of anesthesia and surgery in general are:

• Reactions to medicines or breathing problems
• Bleeding , blood clot , or infection?

Risks of shoulder replacement surgery are:

• Allergic reaction to the artificial joint
• Blood vessel damage during surgery
• Bone break during surgery
• Nerve damage during surgery
• Dislocation of the artificial joint
• Loosening of the implant over time

Before the Procedure

Tell your doctor or nurse what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription?.

During the 2 weeks before your surgery:

• You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve).
• Ask your doctor which medicines you should still take on the day of your surgery.
• If you have insulin? is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।" data-rx-term="diabetes" data-rx-definition="Diabetes is a condition where blood sugar stays too high because insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।">diabetes? , heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
• Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow wound and bone healing.
• Let your doctor know right away if you get a cold, flu, fever?, herpes breakout, or other illness before your surgery.

On the day of your surgery:

• You will likely be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take the medicines your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital. Be sure to arrive on time.

After the Procedure

After the procedure:

• You may stay in the hospital for 1 to 3 days after your surgery.
• While there, you may receive physical therapy? to help keep the muscles around your shoulder from getting stiff.
• Before you go home, the physical therapist will teach you how to move your arm around by using your other (good) arm to help.
• Your arm will need to be in a sling for 2 to 6 weeks with no active movement and 3 months before strengthening. It will be around 4 to 6 months of recovery.
• Follow any instructions you are given about how to care for your shoulder at home. This includes activities that you should not do.
• You will be given instructions on shoulder exercises to do at home. Follow these instructions exactly. Doing the exercises in the wrong way can injure your new shoulder.
• Follow instructions on how to take care of your wound and shoulder after you go home.

Outlook (Prognosis?)

Shoulder replacement surgery relieves pain? and stiffness? for most people. You should be able to resume your normal daily activities without much problem. Many people are able to return to sports such as golf, swimming, gardening, bowling, and others.

Your new shoulder joint will last longer if less stress is placed on it. With normal use, a new shoulder joint can last for at least 10 years.