What is total shoulder replacement surgery? When a patient suffers from severe arthritis (i.e. the cartilage lining has completely worn away) excruciatingly painful bone-on-bone arthritis occurs. Motion is restricted and the pain can be tolerated with some medication (such as cortisone and non-steroidal anti-inflammatory medicines), which is administered via localized injections. Surgery is a recommended and often inevitable outcome, even if the medication has a modicum of success. If you experience any of the following symptoms, you may be at risk from severe arthritis and it may be time to address your shoulder problem: basic activities cause pain, motion is limited, shoulder stiffness, joint swelling and tenderness.
So how does total shoulder replacement work? Pain is permanently alleviated with an artificial replacement – in the form of either a metal- or plastic implant. The shoulder is a rotating joint that has many features in common with the hip joint. Thanks to this socket joint, a massive range of motion is allowed within a health joint. Therefore when shoulder surgery is performed, the ball is removed from the top of the humerus and reinstated with a new metal or plastic implant. A half-moon shape is attached to a stem, which is inserted straight down the middle of the arm bone. Then the socket portion is shaved clean, to be replaced with a plastic socket which is permanently affixed into the scapula. The goal of this surgery is to alleviate pain, not to improve general movement. Patients should understand this before undertaking this lengthy and often complicated surgery.
Also understand that you must undergo a pre-operative health-screening exam to ensure that any potential patient is ready for total shoulder replacement surgery. Do not eat or drink anything on the day of the surgery, as surgeons require the system to be clean before attempting any invasive procedure. Your surgery may range from anywhere between two to three hours, which is of course wholly dependent on the amount of preparation and anesthesia required. Surgeons operate through a four to eight inch-long incision, which is generally performed under local anesthesia. Recovery extends the time with a further hour.
Expect your hospital stay to be between two or three days, depending on the length and difficulty of the surgery. The doctor will send you home with a sling, and patient must of course follow the instructions of the doctor. Many surgeons will attempt to test the motion of your arm immediately following surgery, as it helps to gauge the level of success. It takes a period of three months or more to return to normal activities. The emphasis during this time period is on strengthening the muscle and increasing the active scope of rotational movement.
Some risks are of course associated with the surgery; these are minimal but range from:
• A possible infection around the implant, which is a highly serious complication. In the event of this occurring the entire joint would have to be removed to wipe out the infected area.
• If the surgeon does not balance the soft tissues around the shoulder correctly, the implanted joint may pull out of its socket.
• Damage to the blood vessels or nerve. It must be noted that the shoulder joint is a tightly packed area and any damaged blood vessel can potentially cut off circulation, causing the entire arm to lose function and reach a state of possible gangrene if not immediately addressed. This is a shoulder problem that can be avoided by choosing the best possible surgeon.
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