Total shoulder replacement

What is arthritis?

Arthritis is a group of conditions that cause damage to one or more joints.

The most common type of arthritis is osteoarthritis, where there is gradual wear and tear of a joint.

Some other types of arthritis are associated with inflammation of the joints that can eventually lead to severe joint damage.

Arthritis eventually wears away the normal cartilage covering the surface of the joint and the bone underneath becomes damaged. This causes pain and stiffness in the joint, which can interfere with normal activities.

What are the benefits of surgery?

You should get less pain and be able to move your arm more easily.

Are there any alternatives to surgery?

Simple painkillers such as paracetamol and anti-inflammatory painkillers such as ibuprofen can help control the pain of arthritis.

A steroid injection into your shoulder joint can sometimes reduce pain and stiffness for several months.

All these measures become less effective if your arthritis gets worse and this is when your surgeon may recommend a shoulder replacement.

What does the operation involve?

Various anaesthetic techniques are possible.

The operation usually takes 1 to 2 hours.

Your surgeon will make a cut on the front of your shoulder and remove the damaged ball (head of the humerus). They will examine the socket which lies on your shoulder blade. They will replace the ball and sometimes also the socket. The new ball is made of metal and the socket is usually made of plastic.

Your shoulder replacement is fixed into the bone using a special coating or acrylic cement.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• venous thromboembolism
• chest infection
• heart attack
• stroke

Specific complications of this operation

• damage to nerves around your shoulder
• infection
• severe pain, stiffness and loss of use of your arm and hand
• loosening
• rotator-cuff tears
• dislocation of your shoulder replacement
• stiff shoulder
• surgery to redo (revise) the shoulder replacement

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home after 2 to 3 days.

You will need to keep your arm in a sling for up to 6 weeks to keep the tension away from your shoulder joint.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery, have less pain, and can move about better.

An artificial shoulder never feels quite the same as a normal shoulder and it is important to look after it in the long term.

A shoulder replacement can wear out with time.