Are you having a hard time doing your daily tasks because of the pain and stiffness in your shoulder? Do you feel unbearable pain even when you try to raise your arm, change clothes, or lift a small weight? Perhaps your doctor has told you about shoulder replacement surgery. It's normal to feel a little scared and nervous when you hear this name. But what exactly is this surgery? Is it something to be afraid of? Let's talk about it simply, in a way that you can understand.
Simply put, what is shoulder replacement surgery?
To be precise, this involves removing your worn-out, damaged shoulder joint and replacing it with an artificial joint. In medicine, we call this joint replacement (arthroplasty) .
Our shoulder joint is made up of two parts, a ball and a socket. The ball-like part at the top of your upper arm bone (humerus) fits into a cup-like part on your shoulder bone (scapula) called the glenoid. This surgery involves removing both the damaged ball and socket and replacing them with an artificial joint (prosthesis) made of metal and plastic.
Do you replace everyone's entire joint?
Typically, most people who have a shoulder replacement surgery have the entire joint replaced. That means both the ball and the socket.
But imagine that only one part of your joint is severely damaged. For example, the cup is still intact, but only the ball is worn out. In such cases, your doctor may decide to replace only the damaged part. This is called a hemiarthroplasty . However, this is rarely done, because most of the time, when a joint is damaged due to a condition like arthritis, both parts are damaged.
For whom is this surgery recommended?
Doctors usually recommend this surgery for people who have shoulder problems that cannot be controlled with other treatments such as medication, exercise, and injections. See if you have any of these symptoms.
| Symptom/condition | A simple explanation |
|---|---|
| Severe pain | Having unbearable pain in the shoulder even when resting or sleeping at night. |
| Joint stiffness and limited movement | Having a shoulder that is so stiff that you can't even do simple tasks like raising your arm, bending it back, or combing your hair. |
| Swelling | Persistent swelling around the shoulder joint. |
| Shoulder Arthritis | This is the most common cause, especially in conditions where the joints wear out (Osteoarthritis) and joints swell (Rheumatoid Arthritis) . |
| Rotator Cuff Tear | Severe damage to the muscles and tendons around the shoulder. |
| Loss of blood supply to the bones (Avascular Necrosis) | Bone cell death due to decreased blood flow to the bones of the shoulder joint. |
How do you prepare before surgery?
Your doctor and medical team will help you prepare well before surgery. You will need to undergo several tests.
- Dental checkup: You might be wondering why you need a dental checkup before shoulder surgery. The reason is that infections in the mouth can travel through the bloodstream and cause an infection in the newly replaced joint. This is done to reduce that risk.
- A complete physical examination: Check if your general health is good.
- X-ray, CT scan, or MRI scan: See exactly how much damage there is to the shoulder joint.
- ECG (Electrocardiogram) test: Make sure your heart is functioning properly.
- Blood tests: Check things like blood sugar and kidney function.
Most importantly: You should definitely tell your doctor about all the medications you are taking (those for other conditions, vitamins, traditional medicines). Some medications may need to be stopped a few days before surgery.
You will usually be asked to stop eating or drinking (fast) about 8 hours before surgery. Your doctor will give you specific instructions about this.
What happens during the surgery?
Before the surgery, you will be anesthetized by an anesthesiologist. This means that you will not feel any pain. You may be put completely to sleep (General Anesthesia), or you may be given a local anesthetic to numb only your shoulder and the surrounding area (Regional Anesthesia).
The surgeon then follows these steps:
1. A small incision is made in the skin around the shoulder.
2. Damaged and worn-out bone and cartilage fragments are carefully removed.
3. Instead, the new prosthesis is fitted correctly.
4. The arm and shoulder are repositioned correctly, and the incision is closed with stitches.
This surgery usually takes about two hours , but this time may vary slightly depending on the extent of damage to your joint.
What are the benefits and possible risks of surgery?
As with any surgery, there are benefits and very rare risks.
| Benefits | Rare Complications |
|---|---|
| ✅ Significant reduction in pain: The unbearable pain experienced before surgery is greatly relieved. | 🩸 Blood clotting. |
| ✅ Increased mobility: Difficulty in lifting and performing daily tasks disappears. | 🩹 Infection at the surgical site or inside the joint. |
| ✅ Improved quality of life: You can be happy and active without pain and discomfort. | 💥 Fracture of the bone around the artificial joint. |
| ⚡ Damage to nerves or blood vessels. | |
| ⚙️ The artificial joint becomes loose, comes off, or wears out quickly. |
How is the recovery time after surgery?
After surgery, you will be taken to a recovery room. The medical team will monitor you closely until you wake up from the anesthesia. Some surgeries allow you to go home the same day, but most require a day or two in the hospital .
How long does it take to heal?
It may take several months to fully heal. After surgery, your arm will be placed in an arm sling. You will need to wear this for several weeks .
It is very important to start doing the simple exercises that your doctor teaches you from the first few days after surgery. This will help keep the joint flexible and free from stiffness.
After a few weeks, you will be asked to start physical therapy. A physical therapist will teach you exercises and stretches to strengthen your shoulder muscles and increase your range of motion.
What do you do for the pain?
It is normal to have some pain after surgery. The pain may be more intense in the first few weeks. Your doctor will prescribe pain medication to help control the pain. It is important to follow those instructions exactly.
How do you get used to everyday tasks again?
You should be able to do simple tasks like getting dressed and eating on your own in about two to three weeks . However, you will need to avoid lifting weights, playing sports, or doing strenuous exercise for a few months . Before resuming any activity, check with your doctor to make sure it is safe for you.
How long does this artificial joint last?
If well cared for, this artificial joint can last for years. Many people can use this joint for more than 15 years without any problems. Some people have it well throughout their lives.
Your surgeon may explain this to you, and you may be limited to the amount of weight you can lift with your arm for the rest of your life.
What time should I call the doctor?
If you experience any of these symptoms when you go home after surgery, call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).
| Warning signs to look out for | |
|---|---|
| 🌡️ Fever: Body temperature above 101°F (39°C). | 🩸 Bleeding: Excessive bleeding from a surgical wound. |
| 💔 Chest pain: Sudden chest pain. | 😮💨 Difficulty breathing (dyspnea): A feeling of shortness of breath. |
| 😖 Severe pain: Severe pain that cannot be controlled even with painkillers. | ✋ New hand pain: New pain or numbness in the hand, wrist, or fingers. |
| 🩹 Signs of wound infection: swelling, redness, warmth around the wound, and discharge of foul-smelling fluid. | |
It's normal to feel a little scared and nervous when you hear about this kind of surgery. But remember, this is something that will bring a lot of relief to your life. Even though the recovery period will be a little difficult, you can be proud of the effort you are putting into getting your shoulder back to good condition. Talk openly with your doctor about any questions or concerns you have. Then you will be able to face this journey well.
Take-Home Message
- Shoulder replacement surgery is a very effective and safe solution to severe shoulder pain and mobility problems.
- It will take several months to fully recover. Physical therapy and exercise are very important during this time.
- Follow your doctor's instructions (medication, exercise, and weight-lifting restrictions) exactly.
- If you develop a high fever, unbearable pain, difficulty breathing, or signs of wound infection after surgery, seek medical advice immediately.
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