Shoulder Replacement

A shoulder replacement is used to minimise any pain that might be occurring secondary to any degenerative changes (arthritis) of the smooth surfaces of the ball and socket of the shoulder joint. A shoulder replacement can come in many different designs, and the appropriate implant will be chosen depending on the pattern or severity of your arthritis. If only the humeral head (the ball) is replaced then the operation is referred to as a Hemi-arthroplasty. If the glenoid (the socket) is also replaced then this is referred to as a Total Shoulder Replacement. Other surgical options include whether a stemmed implant or a humeral head resurfacing is undertaken. The choice of implant will be made based on the nature of your disease and on what implant will give you the best clinical result.

Information for patients / operative Information

Risks and complications

• Infection
• Bleeding / Haematoma formation
• Nerve injury
• Stiffness
• Residual discomfort
• Loosening
• Dislocation
• Need for later revision

Before admission

• Please bring any X-rays or scans with you to the hospital. This will usually be on a CD disc. These will not be needed if it was Mr Falworth who organised the investigations.
• No food for 6 hours, or drink for 4 hours, prior to surgery.
• Please avoid smoking for 12 hours prior to surgery

In Hospital

• A shoulder replacement usually requires a hospital stay ranging between 2-4 days.
• A single incision measuring approximately 15cm is made over the front of your shoulder.
• The wound is repaired with dissolving sutures and Steri-strips
• Splash proof dressings will be applied but the wound should remain dry for 10 days.
• Prior to your discharge from hospital, a physiotherapist will demonstrate some simple exercises as part of your rehabilitation protocol. These exercises should be undertaken when you’re at home and will help your shoulder recover from the surgery before your outpatient physiotherapy commences.

What to Expect

• Swelling; immediately after your operation there can be quite a lot of swelling around the shoulder but this settles after approximately 24 hours. A Cryocuff or alternative cold therapy compress, can be helpful in minimising swelling and inflammation. The Cryocuff will usually be issued to you upon discharge
• Pain; an Interscalene Block is often used to reduce immediate post-operative pain. If any discomfort arises once the block has worn off, simple oral analgesics can be taken to manage this. These will be provided to you upon discharge.
• Bleeding; there may be some oozing through the bandages but this should settle soon after the operation.

Post-operative care

• A sling will be provided to help rest the shoulder. This should be worn for six weeks to allow for the muscle repairs that were undertaken during the surgery to heal. To prevent the development of undue shoulder stiffness, the belt that is attached to your sling can be removed 24 hours after your operation. However, you may wish to replace it at night whilst in bed.
• The wound should be kept dry for 10 days.
• At ten days the dressing and paper Steristrips can be gently removed. If the wound is ‘dry’ then it is all right to wash the wound, if not consult Mr Falworth.
• The most important part of your post-operative care is to start an early exercise programme, which the ward physiotherapist will have commenced prior to discharge from hospital. This will maximise the benefit of your operation and will continue as an outpatient.

Post-operative appointments

• You will be reviewed in clinic approximately 3 weeks following your surgery.

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