The upper portion of your arm bone is shaped like a ball. Muscles and ligaments hold this ball against the cup-shaped part of the shoulder bone. Orthopedic specialists perform a shoulder replacement when this area is damaged from arthritis or trauma.
Before the Procedure
During surgery the anesthesiologist will use general anesthesia which means you will be unconscious. Occasionally, your orthopedic specialist prefers to use regional anesthesia, meaning you won’t be able to feel the area he is working on and you will be sleepy but awake during the surgery.
The choice of which kind of anesthesia will depend on your overall health status, what you prefer, and what your anesthesiologist chooses. Also, you will be given antibiotics during and after your surgery to reduce the risk of infection. Many times our orthopedic surgeons want you to get your dental work completed before you have shoulder replacement surgery.
During the Procedure
A total shoulder replacement is done to replace the ends of bones in a damaged shoulder joint. This procedure creates new joint surfaces. During surgery, the orthopedic specialist will replace the ends of the damaged upper arm bone (called the humerus) and the socket (called the glenoid). The surgeon will cap these areas with artificial surfaces made plastic and metal. Shoulder joint components that are placed into the joint must be held in place with cement or they may be made out of a special material that allows new bone to grow into the joint components over time and hold them in position.
Basically, for shoulder joint replacement, your orthopedic specialist will make an incision over the front of your shoulder joint to open up the area he will be working on. Then he will remove the top of your upper arm bone, cement the new prosthetic head and stem in place, and smooth or replace the surface of the old socket. He will then close the incision with staples or sutures and place a bandage over your wound. This surgery usually takes anywhere from one to two hours to complete.
After the Procedure
Right after surgery you will have an intravenous (IV) and antibiotics going through this for one or two days. You will also receive medications that will prevent blood clots and relieve pain. Keep in mind that you will not feel yourself for a few days after surgery due to the effects of anesthesia. You may be constipated, have an upset stomach, and feel groggy or tired.
When you wake up from the procedure you will have a bandage on your shoulder and possibly a drain to collect fluid and prevent it from building up in the joint area. A physical therapist will begin to work with you to perform gentle exercises on your shoulder on the day of surgery or the day after. The sooner you work your shoulder, the better.