to other joint replacement procedures, shoulder replacement
surgery is generally done to address persistent pain
that is not controlled by non-surgical therapy. Less
commonly, poor shoulder motion may also be a reason
for replacement surgery.
The shoulder is a ball-and-socket
joint, with the top of the arm bone (humeral head)
fitting into a socket known as the glenoid. Muscles
and tendons, such as the rotator cuff, help hold the
joint in place. Surgery involves replacing the humeral
head and the glenoid with artificial components. The
humeral head replacement is generally made from a
metal alloy, while the glenoid component is made from
polyethylene plastic. The new components may be anchored
by cement or press-fit into place so that the bone
grows in around them.
During surgery, a three- to four-inch
incision is made along the space between the arm and
the collarbone. The procedure lasts about 90 minutes,
and the incision is then closed with staples or stitches.
Patients typically stay in the hospital for one to
two nights, and full recovery usually takes six to
Arthritic shoulders are stiff.
One of the major goals of total shoulder replacement
surgery is to relieve much of this stiffness. However,
after surgery scar tissue will tend to recur and limit
movement unless motion is started immediately. This
early motion is facilitated by the complete surgical
release of the tight tissues so that after surgery
the patient has only to maintain the range of motion
achieved at the operation. Later on, once the shoulder
is comfortable and flexible, strengthening exercises
and additional activities are started.
A careful, well-planned rehabilitation
program is critical to the success of a shoulder replacement.
You usually start gentle physical therapy on the first
day after the operation. You wear an arm sling during
the day for the first several weeks after surgery.
You wear the sling at night for 4 to 6 weeks. Most
patients are able to perform simple activities such
as eating, dressing and grooming within 2 weeks after
surgery. Driving a car is not allowed for 6 weeks
Here are some
"do's" for when you return home after
your shoulder joint replacement:
- Do follow the program of home exercises prescribed
for you. You may need to do the exercises 4 to 5
times a day for a month or more.
- Do ask for assistance. Your physician may be
able to recommend an agency or facility if you do
not have home support.
- Do avoid placing your arm in any extreme position,
such as straight out to the side or behind your
body for the first 6 weeks after surgery.
Many thousands of patients have
experienced an improved quality of life after shoulder
joint replacement surgery. They experience less pain,
improved motion and strength, and better function.
Here are some
"don'ts" for when you return home
after your shoulder joint replacemen:
- Don't use the arm to push yourself up in bed
or from a chair because this requires forceful contraction
- Don't overdo it! If your shoulder pain was severe
before the surgery, the experience of pain-free
motion may lull you into thinking that you can do
more than is prescribed. Early overuse of the shoulder
may result in severe limitations in motion.
- Don't lift anything heavier than a glass of water
for the first 6 weeks after surgery.
- Don't participate in contact sports or do any
repetitive heavy lifting after your shoulder replacement.
Frequently Asked Questions about Shoulder
- What are the symptoms
to detect Shoulder Replacement?
Patients with arthritis typically
describe a deep ache within the shoulder joint. Initially,
the pain feels worse with movement and activity, and
eases with rest. As the arthritis progresses, the
pain may occur even when you rest. By the time a patient
sees a physician for the shoulder pain, he or she
often has pain at night. This pain may be severe enough
to prevent a good night's sleep. The patient's shoulder
may make grinding or grating noises when moved. Or
the shoulder may catch, grab, clunk or lock up. Over
time, the patient may notice loss of motion and/or
weakness in the affected shoulder. Simple daily activities
like reaching into a cupboard, dressing, toileting
and washing the opposite armpit may become increasingly
How do I know if I am ready for shoulder replacement
Patients who have tried the usual treatments for shoulder
arthritis, but have not been able to find adequate
relief, may be a candidate for shoulder replacement
surgery. Patients considering the procedure should
understand the potential risks of surgery, and understand
that the goal of joint replacement is to alleviate
pain. Patients generally find improved motion after
surgery, but these improvements are not as consistent
as the pain relief following shoulder replacement
- How long is the recovery following shoulder
Hospital stays vary from one to
three days for most patients. You will be sent home
wearing a sling and you should not attempt to use
the arm except as specifically instructed by your
Most physicians will begin some
motion immediately following surgery, but this may
not be true in every case. Usually within two to three
months, patients are able to return to most normal
activities and place an emphasis on strengthening
the muscles around the shoulder and maintaining range
- What are the symptoms of severe arthritis
of the shoulder?
Common symptoms of shoulder arthritis
- Pain with activities
- Limited range of motion
- Stiffness of the shoulder
- Swelling of the joint
- Tenderness around the joint
- A feeling of grinding or catching within the
Can rehabilitation be done at home
In general the exercises are best
performed by the patient at home. Occasional visits
to the surgeon or therapist may be useful to check
the progress and to review the program.
When can I return to ordinary daily
In general, patients are able to
perform gentle activities of daily living using the
operated arm from two to six weeks after surgery.
Walking is strongly encouraged. Driving should wait
until the patient can perform the necessary functions
comfortably and confidently. Recovery of driving ability
may take six weeks if the surgery has been performed
on the right shoulder, because of the increased demands
on the right shoulder for shifting gears.
With the consent of their surgeon,
patients can often return to activities such as swimming,
golf and tennis at six months after their surgery.