What Is Total Shoulder Arthroplasty?
Total shoulder arthroplasty is a procedure that replaces the shoulder with an artificial joint. The surgeon removes the ball of the shoulder and places a metal stem that goes into the arm bone, or humerus, and then adds a metal ball. On the socket side, a plastic piece is cemented into the socket to return this to a smooth surface.
Shoulder Replacement Surgery Length
The procedure takes about two hours. Afterward, you are encouraged to move the joint since a major goal of shoulder arthroplasty is to return as much range of motion as possible. The standard time in the hospital is one to two nights.
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Pain & Shoulder Arthroplasty
At the University of Utah Health Orthopaedic Center, we use a small catheter that is placed near the nerves in the neck to deliver anesthesia. The catheter is connected to anesthesia that runs into the area slowly over a couple of days. Because of this unique system, you will feel minimal discomfort, and the procedure is highly accurate.
Because of this it is very common for arthroplasty patients to have minimal to no pain over their first couple of days after surgery. This allows you to start well after surgery since you won’t be sick from other medications, you can eat well, and be very mobile overall.
Complications of Shoulder Arthroplasty
The complications include:
- blood loss,
- nerve injury,
- loosening of the replacement parts,
- dislocation, and
- fractures around the implants among others.
The specialists at the orthopaedic center give you preoperative antibiotics to counter infection. Our patients also rarely need to give blood transfusions and find that while nerve injury can occur, it is usually temporary (although, a permanent neurologic injury is possible but rare). Also, the components that are placed in the joint can be revised or removed.
Shoulder Replacement Recovery Time
The shoulder tendons are usually healed by six weeks, and you can use your shoulder normally. We anticipate a full recovery by six months, which allows return to almost all normal activity.
After arthroplasty we try to start physical therapy early and emphasize range of motion. We feel that the patient and his or her family needs to be primarily involved with this and don't rely exclusively on formal physical therapy. However formal physical therapy can be very useful.
Depending on where the patient lives we try to make this as convenient as possible and give the patients instruction sheets on how to obtain motion and use of their shoulder.
Shoulder Replacement Limitations
Because this is an artificial joint, we discourage heavy lifting-type work with the shoulder. Significant overhead work may be difficult. However, you should be able to perform routine daily activities, like golf, swimming, bicycling.
Currently, approximately 85 percent of the shoulder joints replaced are still functioning well at 10 years.