Shoulder Joint Replacement
Shoulder joint replacement is an operation that is frequently done for shoulder pain caused by severe arthritic damage in the shoulder. The surgery is similar to total hip surgery in that the diseased ball and socket of the shoulder are resurfaced and replaced with prosthesis.
Why do I need x-rays?
X-rays provide us with a road map of your shoulder. They tell us how severe the arthritis is and give us an idea of the proper size of the shoulder replacement, which will be necessary. If any special techniques will be required to repair the problem (such as bone grafting, or a specially made shoulder prosthesis), these too can be determined by evaluating your x-rays.
When will I be admitted to the hospital?
We are all concerned with the rising cost of health care. We are lucky to be living in the United States, where we can have access to the best health care system in the world. We have to protect that privilege. For that reason we will not admit you into the hospital until just before your total shoulder replacement. In some cases, that will be the morning of the operation (this is due to Medicare regulations). You can expect that your preoperative blood tests, electrocardiogram, chest x-ray, and other studies will be completed approximately one week before your surgery as an outpatient.
What happens before surgery?
Before your admission to the hospital, you will be seen in our office for preoperative planning of your surgery. An autologous blood donation schedule will be determined for you. With autologous blood donation, you will donate two or three units of your own blood at the hospital blood bank. This is done within the month preceding your surgery. Your own donated blood will then be given back to you during or after your surgery. Autologous blood donation admonishes the risks of blood transfusions, particularly exposure to the HIV virus (AIDS virus), and the hepatitis virus. Supplemental iron therapy will also be prescribed at the onset of your autologous blood donation program. Approximately one to two weeks before your surgery, you will be seen in our office for a preoperative examination during which your health history will be reviewed and a physical examination will be performed.
What happens after admission to the hospital?
After your admission to the hospital, you will meet the nurses who will be taking care of you. They will show you around the orthopedic floor, and will answer questions about how to get any assistance you need. Before surgery, the nurse will assist you in cleansing your operative shoulder area to prevent infection. You may have an intravenous line inserted. You will not get an enema!
How long does the surgery take?
This depends on how quickly you heal and how quickly you regain your strength, usually three to five days. You will be seen by a physical therapist the first day following your surgery to begin flexibility exercises. You will be a little sore, but it will get easier each time. Besides, you will have plenty of help. Along with the physical therapist, there will be specially trained orthopedic nurses to assist in your care. You will learn how to get in and out of bed the proper way and how to get to the bathroom and care for yourself. Don't be concerned, our staff has lots of patience and plenty of experience. When you can do these activities by yourself, you will be ready to go home. If you need additional assistance at home in the way of home health care and physical therapy, we will help you arrange that too.
How long will I be in the hospital?
This depends on how quickly you heal and how quickly you regain your strength, usually five days. Immediately following the surgery, the CPM machine will be applied to the knee to begin gentle flexibility exercises. We will start slowly by helping you get out of bed on the first day after your surgery, You will be a little sore but it will get easier each time, besides you will have plenty of help! Not only are the nurses specially trained, but we have a physical therapist who will assist you. You will learn how to get into and out of bed the proper way and how to get to the bathroom and care for yourself. (Don’t be concerned, our staff has lots of patience and plenty of experience!) In addition to the CPM machine, a physical therapist will also assist you with straightening and bending your knee as well as learning how to walk properly using a walker while in the hospital. When you are able to get into and out of bed yourself, get into and out of the bathroom, and can walk without assistance, you will be ready to go home, If you need additional assistance at home in the way of home health care, we will help you arrange that too.
“How about that therapy, Doc?”
I always tell my patients that there are two parts to the operation. The first is the part that I do, and that usually finishes when they leave the hospital. The second is the part that they do, and that begins the moment they wake up. You need to start moving your shoulder immediately with gentle range of motion exercises as well as using your arm for normal activities of daily living. This would include feeding yourself and helping yourself get dressed.
How about the exercises I am supposed to do?
Physical Therapy Department will assist you in exercises which are aimed at strengthening your muscles and obtaining absolute full range of motion. It is very important to start the therapy early and to do it diligently until it is completed and end results are met, otherwise the result of this operation will not be as good as either your or I would like to see.
When will you see me again?
Most patients with total shoulders will be seen in the office between seven and ten days after surgery. At that time we will evaluate your wound and possibly remove your staples or sutures. You will continue to work in physical therapy to gain strength and flexibility of your shoulder at home. We will see you intermittently after this point to provide optimal results.