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Shoulder Replacement

Total or partial joint replacement with a prosthetic joint has become a more common treatment to relieve pain and restore independence. Most joint replacements are done for hips and knees, but shoulder replacement is becoming more and more popular as a remedy for arthritis and fractures of the shoulder. Shoulder replacement is recommended to repair painful arthritic shoulders and increase limited motion. Replacement involves the replacement of just the head of the humerus (hemiarthroplasty) or the entire shoulder joint (total shoulder arthroplasty).

More recently, the reverse total shoulder arthroplasty has emerged as an excellent surgical option in patients who are not candidates for a total shoulder arthroplasty.

The Shoulder Joint

There are two bones that form the glenohumeral (GH) joint, the main joint of the shoulder: the scapula (shoulder blade) and the humerus. The GH joint is a ball-and-socket joint, similar to the hip joint.  It is the most mobile joint in the body.

The glenoid is the shallow, recessed, portion of the scapula that forms the socket of the GH joint. The humerus has a ball-shaped head which fits into the glenoid socket to form the GH joint.  The head of the humerus (ball) and the glenoid (socket) are both covered in slick hyaline (or articular) cartilage, which allows smooth and pain-free shoulder motion. The GH joint is stabilized by strong ligaments and muscles. The main groups of muscles that acts to stabilize the GH joint are the rotator cuff muscles.

See Shoulder Structure, Function for more information about shoulder anatomy.

Causes for Shoulder Joint Replacement

Shoulder replacement may be a surgical option when there is severe destruction of the GH joint from osteoarthritis, rheumatoid arthritis, osteonecrosis (bone death), or trauma. Ultimately, if any of these conditions results in a painful and dysfunctional shoulder that makes it difficult to dress and care for oneself, shoulder replacement may be a good treatment option.  It is important to remember that shoulder replacement is an elective surgery in most situations. This means, that most commonly, you decide when it is time to have your shoulder replaced.

The most common reason to undergo shoulder joint replacement is osteoarthritis. To make things simple, osteoarthritis is the wear and tear-type arthritis. The slick articular cartilage that covers both joint surfaces (the ball and the socket) that allows for smooth and pain-free motion ultimately wears down with time. In end-stage osteoarthritis, all of the cartilage is gone, causing bone to rub on bone.  This may lead to a very painful and poorly functioning shoulder.

While osteoarthritis is more common in the weight-bearing hip and knee joints, it also commonly affects the shoulder joint. Trauma, like fractures or dislocations of the shoulder, can unfortunately accelerate this process.

Rheumatoid arthritis, which is an inflammatory type arthritis, can also result in progressive destruction of the shoulder joint leading to pain and poor shoulder function.

Osteonecrosis (bone death) of the humeral head can also result in a very painful and dysfunctional shoulder. Osteonecrosis is a condition where the blood supply to a particular bone is cut-off. Eventually this causes the bone to die. In the shoulder, osteonecrosis can occur for numerous reasons including fracture and steroid use. People with various blood diseases like Sickle Cell disease are also at risk.

Sometimes, a surgeon may recommend shoulder replacement with severe fractures of the humeral head. Severe cases of rotator cuff tears, particularly if accompanied by severe arthritis, may also be treated with a special type of shoulder replacement called a reverse total shoulder arthroplasty.

Surgical Options for Shoulder Replacement

Replacing or reshaping the damaged or diseased joint with a prosthetic one is called an arthroplasty. Depending on your age, overall health, and your specific shoulder joint problem, your surgeon may recommend one of the following procedures:

• partial shoulder replacement (hemiarthroplasty)
• partial shoulder resurfacing
• reverse total shoulder replacement
• total shoulder replacement

Hemiarthroplasty replaces the head of the humerus with a prosthesis. The glenoid surface is left alone. Hemiarthroplasty can be done to repair a fracture of the humeral head or neck when the glenoid cavity isn’t affected and is still functional. Besides fractures, other indications for hemiarthroplasty include:

• osteoarthritis
• osteonecrosis of the humeral head
• Tumors of the humeral head
• Rotator cuff tears that can’t be repaired, especially if accompanied by severe arthritis

Shoulder resurfacing replaces the surface of the humeral head with a metal covering, or cap. The glenoid surface may also be replaced using a plastic prosthesis. Shoulder resurfacing may be an option for younger, active patients with:

• osteoarthritis
• osteonecrosis of the humeral head
• Rotator cuff tears that can’t be repaired, especially if accompanied by arthritis

A major advantage of resurfacing is that it preserves bone for future shoulder procedures and surgeries. However, resurfacing is not recommended when severe bone loss is present or if the bone is not healthy enough to support the prosthesis.

Total shoulder arthroplasty replaces both the humeral head (ball) and glenoid (socket) with a prostheses. Usually the ball is metal and the socket is made of plastic. Total shoulder replacement is used when there is severe destruction of both the humeral head and glenoid surface from osteoarthritis, rheumatoid arthritis, osteonecrosis, or trauma.

Reverse shoulder replacement prosthesis Reverse total shoulder replacement converts the head of the  humerus from its normal ball structure to a socket and the normal glenoid socket into a ball. Ergo, reverse total shoulder arthroplasty. This change in the normal anatomical relationship allows us to use the deltoid muscle to compensate for the loss of function of the rotator cuff. Therefore, the main indication for this surgery is pain, and functional loss due to a severe rotator cuff tear that cannot be repaired (irreparable).  Oftentimes, this leads to significant arthritis known as cuff tear arthropathy.  Additionally, the reverse total shoulder replacement is sometimes used for the treatment of severe fractures of the humeral head and neck.

To be a good candidate for this surgery, you must have a functional deltoid muscle and a lifestyle that will put a low demand on your shoulder. Although reverse shoulder replacement is relatively new, it has emerged as a successful treatment for patients in the right situation.

Getting Ready for Shoulder Surgery

The decision of going ahead with shoulder replacement surgery should be made together with your surgeon after you have undergone a thorough orthopedic evaluation. The surgeon will tell you the alternatives of having surgery, the benefits of having shoulder replacement surgery, and the risks involved so that you can make an informed decision. If you have any questions or concerns, you should get them cleared up before signing the informed consent form. By signing the consent form, you are saying you know why you are having the surgery and that you understand the risks, benefits and alternatives of surgery and agree to the procedure.

Its important to remember that in most situations, shoulder replacement surgery is not an emergency. There are many non-surgical options that should be tried first prior to deciding to proceed with surgery. Be sure to work with your surgeon to discuss these options.

Risks of Shoulder Replacement

The risks of having complications vary from person to person. That’s because each persons health status is different. Complications differ as well, depending on the type of shoulder replacement being performed. While generally speaking, complications are uncommon, they are nonetheless, real risks that need to be heavily considered before deciding to proceed with surgery. Problems that can occur after shoulder replacement include:

• Infection (most susceptible within the first two years)

• Instability of the glenohumeral joint

• Dislocation – most likely to occur during the healing process, which is why it’s important to wear the shoulder immobilizer
• Stiffness in the shoulder – following your physical therapy routine can help prevent stiffness
• Component failure or loosening, which will lead to additional surgery
• Incomplete pain relief
• Rotator cuff tears
• Fractures of the humerus or glenoid
Deep vein thrombosis
Pneumonia
• Nerve injury

As with all surgery, there are also risks associated with undergoing general anesthesia, including heart attack, stroke, and even death.

Pre-op Tests and Preparation

If you decide to proceed with surgery, depending on your age and overall health, your surgeon will likely have you see your primary care physician for a pre-operative work-up.  If you have known heart conditions, this may also include a visit to your cardiologist. Your surgeon may also order tests such as:
• urinalysis
• chest x-ray
• EKG
Blood tests (depending on your medical history)

These tests are to make sure that you are healthy enough to have surgery and to prevent possible complications during and after surgery.

If you are taking certain medicines like aspirin, ibuprofen, or other anti-inflammatory or arthritis medications, you may be asked to stop taking these a week or two prior to surgery. These medications can thin the blood and cause excessive bleeding during surgery. Also, be sure to tell your surgeon about any other medicines that you take so that he can advise whether to stop taking them. Also, if you get a cold, flu, cough, or infection prior to your surgery date, let you surgeon know because your surgery may have to be postponed.

If you are a smoker, you should quit smoking as far prior to surgery as possible, as smoking can cause complications during the surgery and slow down healing.

Your surgeon may also have you visit the physical therapist that will be taking care of your rehabilitation after surgery. The therapist will be able to prepare you for the surgery and get to know your physical condition before the surgery. This will make it easier for the therapist to offer the best treatment and therapy exercises for you after surgery.

Getting Your Home Ready for Your Return

Arrange your home for your return before you go for surgery. You will need some help after the surgery as you won’t be able to move your shoulder or arm. Arrange for a family member or friend to be with you all the time for at least the first week after surgery. You also need to arrange for transportation to and from the hospital for surgery as well as for follow-up visits after surgery, since you will not be able to drive for six weeks or longer.

You may not be allowed to take a shower for a few days following surgery, so you’ll need help with a sponge bath. You also want to prevent falls of any kind, especially in the shower. Putting up temporary handrails in the shower will help you step safely in and out.

Your arm will likely be in an immobilizer sling and you may not be able allowed to do much with your arm after surgery. Go through your home and make sure that any items you will need access to are placed at waist level so you can get to them easily.

Going for Shoulder Surgery

Usually, on the day of the surgery, you will be admitted to the hospital or surgical unit early in the morning. The night before surgery, you must not eat or drink anything after midnight. Bring anything to the hospital your surgeon has asked you to bring including medications that you are currently taking as you may be in the hospital for a day or two. Take a shower and wash your hair before admission—it will be hard to wash your hair after surgery because you can’t raise your arm. Try to get to bed early and get a good night’s sleep.

Shoulder Surgery

On the day of surgery, you will be asked to arrive a couple of hours prior to surgery. If you have not already met with the anesthesiologist, the anesthesiologist will evaluate you before surgery. Usually, in total shoulder replacement surgery, regional anesthesia is used. This consists of a nerve block, where the shoulder region and arm are made to feel numb. This can last for up to a 1/2 day after surgery.

The surgery itself takes about 1 – 2 hours, however, the whole surgical process can take up to 6 hours (getting put to sleep, waking up, etc.). When the procedure is complete, the typical 4-6 inch surgical incision is closed with either stitches or staples, covered with a bandage, and your arm is usually immobilized with a sling.

In the Recovery Room

After surgery, you will be taken to the recovery room where you are monitored until you wake up and/or the effects of the anesthesia wear off. This usually takes about 1-2 hours.

To help prevent blood clots in the legs, you will likely be wearing compression stockings and a sequential compression device. You may also be given anticoagulation medicine. To further prevent blood clots, you need to get up and walk around soon after surgery. Your arm will be in a sling and may affect your balance, so be careful when you first try to walk.

From recovery you will be taken to your hospital room where you will stay for usually one to two days depending on your progress. You’ll be asked to breathe deeply and cough frequently in order to relieve any lung congestion from surgery.

Pain control is very important after surgery. Controlling pain allows you to take deep breaths, get up, move around, and participate in physical therapy—all of which decreases complications from surgery. Pain medications will likely consist of both intravenous (injectable) and oral medications. Talk to your surgical team beforehand about any concerns regarding pain control. 

A special cooling machine made to fit the shoulder may be used to help and relieve pain and swelling of the shoulder area. This is usually started in the recovery room and typically costs extra. Your surgeon may send you home with the ice machine or have you use ice packs to control pain and swelling.

It may take up to a 1/2 day to regain total feeling in the affected shoulder and arm if you received a regional block. Once your regional anesthesia wears off, move your fingers and make a fist off and on to help to maintain the blood flow to the area and speed healing.

Sometimes, the surgical team will places a drain in your shoulder during surgery. If they have, it is usually removed the day after surgery unless there is still a lot of drainage.

More recently, same-day (outpatient) surgery is being done at some centers for shoulder replacement surgery based on health status. If you had same-day surgery, you will be allowed to go home when the effects of anesthesia have worn off, you’re past the stage where complications are likely to occur and you’re pain is reasonably controlled. A nurse usually reviews home-instructions with you, helps you get your prescriptions, and tells you when to make a follow-up appointment with your surgeon. He/she will also instruct you on what to do if you have problems when you get home.

The stitches inside your shoulder (under the skin) will dissolve, stitches or clips in the skin will be removed 10-14 days after surgery. Keep the incision dry until it is well healed.

Recovery and Home Care After Shoulder Surgery

Wearing a Sling

You will likely be wearing a special sling that immobilizes the shoulder when you come out of surgery. The sling has a strap that goes around your waist. Your elbow should fit far back into the sling; the sling should support and cover your wrist and hand up to your knuckles. Your fingers should be exposed so you can use them. The sling provides support, decreases swelling, and increases comfort while your shoulder heals. Your surgeon will tell you how and how long to wear the sling—usually 4-6 weeks. You will be shown how to take the sling on and off so that you don’t injure your shoulder. Do not remove your sling except to dress, shower, and do your physical therapy exercises. For the first 6 weeks, all activities of daily living should be done using your “good” arm.

You must wear the sling even in bed. It’s best if you lie on the opposite side or your back. Use pillows to help you get comfortable and keep you from rolling onto your affected shoulder during the night. Do not lie on your affected side for the first 6 weeks, or until your surgeon says it’s OK. Some people find it easier to sleep in a recliner with pillows to support their arms.

Weight Bearing Activities While Healing From Shoulder Surgery

You will likely have limits on the activities you can do with your shoulder (depending on the surgery that was performed). Some of these include:

• do not pull objects toward your body
• do no roll your shoulder backward
• do not take your elbow behind the body
• avoid putting weight on the affected arm
• do not use the affected arm to push up from a sitting position
• do not use the affected arm to lift objects
• do not use the affected arm until your surgeon says it’s OK

It is very important that you fully understand your individual restrictions.  Take extra time to review these with your physical therapist and surgical team while in the hospital.

You may be allowed to shower 72 hours after surgery if you cover the surgical incision and dressing with plastic wrap. If you’re not to take a shower, take a sponge bath until after the staples or sutures are removed (usually 10 to 14 days after surgery) and the incision can get wet. Don’t bathe in tub or soak in a pool or hot tub where the incision is under water for at least 1 month. Again, review these instructions with your surgical team.

Physical Therapy in the Hospital

A physical therapist will likely work with you in the hospital and teach you the proper way to do exercises that you will continue once you get home. Make sure you carefully follow the home exercises the physical therapist gives you. Do not overdo the exercises even if you feel like you can. Do your exercises exactly as prescribed. Ask, ask, ask, if anything is unclear to you. Improper use of the joint while it is healing can lead to permanent problems or need for additional surgery.

When to Call Your Surgeon

Shoulder replacement is usually a very successful operation, but like any other surgery, there are associated complications as listed above. Call your surgeon immediately or go to the nearest emergency department if you experience any of the following once you get home:

  • If you are having chest pain or difficulty breathing.
  • If your arm, thigh, or calf, begins to swell or becomes increasingly painful
  • If you notice any discoloration of the arm
  • If you notice any progressive numbness of the affected arm after the regional block has worn off, or if the block never wears off
  • If pain in your shoulder gets worse or uncontrollable despite proper use of medication
  • Any fevers higher than 101.5°F
  • If you experience any excessive nausea or vomiting
  • If you experience continued draining or bleeding from the surgical incision
  • If any signs of infection around the surgical incision: redness, swelling, hotness to touch, pus-like drainage

Keep 24-hour phone numbers handy. Call your surgeon’s office if you feel you are not healing as you should. Check your incision every day when you change the bandage for signs of infection and to make sure it is healing as it should. If you think you have a fever take your temperature. If you have signs of infection or other complications, call your surgeon right away.

It is important to remember that with any joint replacement surgery, continued drainage is a big problem and a significant risk factor for infection! Let your surgeon know right away if your wound is continuing to drain.

If the signs tell you it’s an emergency and you cannot reach your surgeon, call 911.

Physical Therapy Program After Shoulder Replacement

Restoring movement to the shoulder and arm is a very critical factor in recovering from shoulder replacement surgery. Soon after the surgery, the surgeon or physical therapist will teach you exercises that will prevent your wrist, elbow or shoulder from becoming stiff, which will speed up your recovery. Make sure you understand the expectations regarding physical therapy following surgery.

When you begin your first therapy sessions, pain may make it difficult for you to do the exercises. Slowly, it will get easier each day. Initially, expect to need some pain medications before and after therapy to help with the pain.

See Shoulder Rehab to learn more about rehab exercises for the shoulder.

Long-term Care for Your New Shoulder

Most importantly, keep your follow-up visits with your surgeon and perform your therapy exercises as advised. It will take time for you to get back to your normal activities. Depending on the type work you do and the type of surgery performed, you may be able to return to work in 8 weeks. If you have a physical job, it may be much longer. Do not drive until your surgeon says it’s OK.

The fastest way to achieve total recovery long-term is to stay active by walking, dancing, doing yard work, and, if OK with your surgeon, playing golf or swimming. These exercises will increase your strength, flexibility, and build endurance. It is important to discuss with your surgeon if there are any restrictions on how much weight you can lift and what activities you should avoid long-term.  Oftentimes, these long-term restrictions differ depending on the type of surgery you had.

It is possible that your surgeon may have you take antibiotics before any future invasive medical or dental procedure in order to decrease the risk of infection in your shoulder. Make sure you have this discussion with your surgeon.

Traditionally, shoulder replacements have a life expectancy of 10-20 years depending on how active you are with your new joint. Being very active puts added demands on your new joint and may reduce the life of that joint.

Recovery Timetable (can be variable):

  • 3 months after surgery: most patients are reasonably comfortable; have motion of about half of normal, but notice they have some weakness.
  • 6 months after surgery: most patients are pain-free (although weather has some effect); they have motion and strength of about two-thirds of normal.
  • One year after surgery: about 95% of patients will be pain-free, and the remaining 5% will usually have no more than a weather ache or an occasional ache with over activity. There probably won’t be significant strength limitations depending on the condition of the rotator cuff and deltoid muscle.

Note that the information in this article is purely informative and should not be used in place of recommendations from your surgical team. 

Comments

  1. Lori Shambarger says

    I really truly feel for anybody that is gone through total shoulder replacement and ended up with nerve damage the doctor hasn’t even done MRI for me. and they did my operation on November 26th. Every time I talk to my doctor about the pain and the nerve pain ,I just had my neck surgery I had it fused together on a August 31st so hes playing blame the neck doctor even though I’m not having any problems with my neck so nobody wants to take responsibility and I’m in a loss I have kids I don’t know what to do I have no use my wrist and can only put things in my fingers and hold them I can’t use them and I feel like I have a muscle tearing in my arm and nerve pain is just like lightning shooting from my shoulder clear down into my finger tips it is horrible!! I hope nobody else has an experience like this or at least they have a better doctor than I do he’ll only treated for pain for 2 weeks after surgery I wish I were known that I would have found a different doctor

  2. Patricia Denman says

    Total shoulder replacement due to extensive fracture of dominate r arm. Emergency surgery? Performed next day. Did not know ? to ask. Not told what to expect post surgery. Due to sensitivity to salycilates unable to use pain meds. Acetomenephen became ineffective after 2 months. Lots of debilitating pain after physical therapy. 7 mo later find out recovery may take 2 yrs. Therapist makes me feel like I am unusually slow to advance physically. Adds several new exercises at a time when I feel just 1 a week or every 2 weeks would be sufficient as more puts me in so much pain I feel I lose ground for several weeks. Also just found out it is important to exercise rest of body, not just shoulder. I am 83 and very active until having fall. Will increase total activity but feel discouraged by lack of communication and patient education from medical personnel. My ortho surgeon declared me released with no more follow up at 3 mo. I almost feel like I am on my own or might as well be and probably would be better off.

  3. Cindy Schmidler says

    It will be good to consult your care provider regarding this issue. Keeping up with physical therapy or exercises may be helpful in maintaining or improving range of motion for you.

  4. Peg Cannell says

    I have partial necrosis of my right shoulder ball. If I do nothing will it stay the same? I can live with the pain as it is now though I have lost some range of movement.

  5. Just had shoulder replacement surgery two an a half weeks ago. Had put it off for a few years til the pain was so bad that I couldn’t stand it any longer.
    (Both shoulders were bad).
    My advice to any one going to have this done. Research Doctors. Doctors that do shoulder an elbows surgery only.
    Not just any an all orthopedic surgeons
    Get that specialty please. Your be glad you did
    I’m doing good. As you know it’s a slow process. An is depressing not being able to do things. But I don’t have that awful pain now
    Besides couldn’t do a lot of things before.
    Having difficulty getting some of my clothes off with both arms.
    The left arm will be done in a few months
    I’m 77 years young.
    This is the 4 th joint replacement that I’ve done in my body.
    LOOK for that SPECIALTY DOCTOR PLEASE‼️

  6. I’m glad that you mention that you should get your home ready before your surgery so that you can be more comfortable and prepared afterward. Surgery can take a lot out of you, so it’s good to be as prepared as possible beforehand. Because it can take a toll on your body, it’s important to consult with your doctor to see if it’s the right option for you.

  7. How big a problem is numbness in my right hand (onset Oct. 2017) after complete reverse right shoulder replacement on Nov. 2016 . What can I do about it?

  8. Jean Haskins. says

    I am 85 yrs.age. I am planing a shoulder joint replacement surgery. Am i at risk for any problems with this.

  9. I had shoulder replacement 6 years ago but iam still in great pain also in the arm , physio has told me i have not got any muscel in that area and have given me exercise to do daily,my left shoulder may be the same ;problem but to frighten to have the same opperation.

  10. marty schram says

    had total shoulder replacement jan.2017-been going religiously to pt 2xwk-now april 2017 surgeon stated my shoulder is not where it should be at this time recommends going back in to correct issue or receive a different prostheic implant???he will evaluate me in july 1017

  11. I have had total shoulder replacement 4 months ago all is well but no feeling in subject hand or fingers . Will that get any better

  12. Vicky Pilla says

    I had my total reverse shoulder 4 weeks ago and I’m doing well. My question is I need a dental implant and want to know how long I have to wait for having that procedure?

  13. Crystal says

    My doctor told me I need a shoulder replacement due to bone on bone joint due to arthritis. I am 63 years old have limited range of motion, pain and weakness.. He told me that the life of a shoulder replacement is 10 years and then there is not enough bone to redo it. So I guess I am waiting until I can’t move it and get a little older and maybe they come up with a better procedure.

  14. I had total shoulder replacement on December 29, 2015. I had a few good weeks and then one day doing physical therapy, my shoulder popped. I went in for x rays and they said my joint is fine, but ever since then I have had severe stabbing pain, and lost some of my range of motion. My surgeon says my joint is fine, but to me it feels like there is a torn muscle. It is almost 13 weeks and I still do not have good active range of motion and they want me to see a pain specialist. Do you think I should get a MRI, CT scan or ultrasound to see if there is a tear, or just get a shot to ease the pain so I can get back to work?

  15. My Dr tells me I need a total shoulder replacement. I have had both hips and a knee replaced and am especially pleased with my flexibility with my knee. If I am faithful with physical therapy what sort of movement restoration can be typically expected. I saw the surgeon several months ago and he was surprised at my good range of motion. My pain has increased since then and my range of motion is only limited by pain.

  16. I had a reverse shoulder replacement on 9/30/2015, I was doing PT & thought I was doing great until I had to have another surgery on 20 Oct. 2015 I’m 74yrs old & pretty active,though I have osteoarthritis in my back etc. I developed tendinitis in my shoulder in late Dec.2015
    I’m having trouble w/pain most of the time. How long will this last? I’ve rested it & took a pres. for 4mg prednisone. No relief, any suggestions?
    One more thing my bi-cep feels like I have a blood pressure cuff on it several times a day(it will squeeze & release) anyone else have this?

  17. I need a total shoulder replacement. Is it normal to have pain in your upper arm (bicep)?? Judi

  18. I had a total shoulder replacement in July. Now, 6 months later my shoulder is in pain and has a burning sensation. I am told that it is highly likely that I have an infection. I have to have a procedure done where fluid is pulled out of the area for testing. Then I will have to have the prothesis removed for several weeks as antibiotics are inserted then an other surgery to put it back in. The first surgery was difficult and I am devestated. Isn’t there another way to treat the infection? I don’t have the energy to go through 2 more surgeries. What can cause an infection?

  19. Dear madam/ sir.
    I am a 80 years old with diabetes, high blood pressure , under active thyroid, all controlled with madications.
    My surgeon wants me to get a Reverse Shoulder Replacement in three days but I have a cold for seven days, thanks to your information I will postpone the surgery for two weeks.
    Do I need this surgery? I need help with my left arm to lift my right arm, have some range motion limitation, some pain when I try to use the arm. The MRI among some other imperfection shows “Large full thickness tear of the distal supraspinatus tendon measures 4 cm medial
    to lateral cm anterior to posterior”.
    I have been active al my life, presently I do exercises for adults Yoga, Ty chee, stretching , and water exercise five days a week. I consider myself for my age , better than de average.
    Thank you for your help. Geo.

  20. I would just like t get some straight answers. I had a reverse shoulder replacement last year. Now, the doctor wants to do the other one. I am in a lot of pain and doctors in Florida are refusing to prescribe Hydrocodone now. My questions are: What will happen if I refuse the surgery? Will the pain get worse? Will I lose the use of my arm? My doctors won’t give me a definitive answer, which I understand, but can someone, who has gone through this tell me what to expect? Thanks

  21. bryan flake says

    I was playing football with my brothers recently. He slammed me into the ground sideways and I wrenched my shoulder. My general practice doctor tells me that I need to get looked at by a specialist possibly for a surgical procedure. What are some great questions to ask? http://www.andrewkerstenmd.com

  22. Media Partners says

    I am so sorry to hear that. Make sure you contact your doctor and give the details and ask about physical therapy options.

  23. Would never do it again. Pain and suffering 1000 worst after shoulder replacement. Dono do it

  24. Katrina Sim says

    Hi I had a partcial shoulder replacement 9 days ago.
    This was due to rhuematoid arthritis.
    I am 35 years old.
    I find sleeping very difficult as I can’t get comfy.
    Any ideas?
    I have my first outpatient phsyio apoinent tomorrow.
    From the hospital I can do all the phsyio exercises, except one.
    Is it normal to not being able to lift my arm up above my head?
    I can only lift it a little bit, with support from my other arm
    I can lift it to about 45•
    Will this get better?
    Worried about this.
    Please help. Thank you

  25. Media Partners says

    Barbara Paytas

    In general, one should consider surgery when they can no longer do their activities of daily living – getting dressed, eating, etc. Sounds like you are ready to consult a surgeon and get medical advice and an opinion. Be sure to ask the surgeon to be as specific as possible about your situation and what outcome you can expect.

  26. Barbara Paytas says

    I’ve been having trouble with my shoulders for over a year. The right one is totally bone on bone. Have gone to therapy with acupuncture, natural injections (can’t take cortisone) and exercises. Has been a big help. But after I was released I aggrevated it by pushing my handle bar, wheeled walker while on a cruise for a week. Therapy really helps but I can’t afford to keep going forever. The pain is severe. Trouble driving, moving the gearshift, pulling the covers over my body, trouble sleeping, getting dressed etc. I haven’t seen my doctor for about a year. I think I’m ready for the shoulder replacement, but I’m scared!! Does it sound like I’m ready to you?? My husband even has to cut some meats for me. I’d appreciate a response from you. I’ve liked what I’ve read so far from this site.

  27. Hello, I had a total shoulder replacement 9 weeks ago. I am visiting the physio twice weekly and doing the prescribed exercises 3 times a day. I still can’t lift my arm up more than about 45 degrees. Is that normal? I’m starting to get worried.
    Regards
    Terri

  28. Media Partners says

    Do you live near a teaching hospital? They may be able to offer some help and alternatives.

  29. Hi,
    I’m 47 and the shoulder surgeon says I need a reverse replacement due to a torn rotator cuff that didn’t heal and severe arthritis. I am scared that this prosthesis will not last very long, they seem to give it about 8-10 years. I am really young to need this. I can’t get a second opinion because the dr.s say no when they find out I had a previous surgery. 1 1/2 yrs. ago I was opened up and found to have a massive infection, so they debrided it, sewed the supraspinatus and closed it, not really the surgery that was intended.
    Anyone have thoughts as to where I go or what I could do? I’m in a corner, and this appears to be the only thing to do.
    Kim

  30. Thank you for your reply. Sound advice. I’m going to ring the physio today. I have two great boys, 12 + 14, and have drawn them up a job rota for the summer hols of helping with dinners and hoovering – which so far they are happy with!!! Have got the books ready and a dog that needs walking so all set. My friend who is a nurse told me of a colleague who had a similar operation who felt good, over did things and ended up having the operation re-done a year later!

  31. Media Partners says

    Andrea, Good for you that you are having a good recovery. I can’t believe you’re not taking advantage of your husband and catching up on your reading! hahaha You should always ask your surgeon before you do anything you are unsure of or start any new activities. If your good arm is not bothering you, use it to do your regular activities of daily living. It’s probably not a good idea to lift anything really heavy or do something that would make you want to use your bad arm to “help out.” It’s important to get plenty of rest and let your body use its energy to heal instead of sweeping floors. 🙂 This is a good time to go window shopping and walking. If you go shopping, carry your handbag on your good arm. Walking is good for preventing blood clots in the legs and increases circulation. You will probably be going to physical therapy soon and those exercises will keep you busy. Ask your physical therapist what you can do.

  32. Your site has been such a help to me both before and after surgery. I am 46 and have rheumatoid arthritis resulting in the need for a full shoulder replacement. This was carried out on the 4th July 2012 by Mr Hartley at The Royal Bournemouth Hospital, Dorset. Sadly it was changed to a partial replacement as my shoulder was so weak that it started to fracture. However, i have very little pain or discomfort and would recommend the operation to anyone who might be unsure. Would just like to know whether I can do a few things around the house with my good arm without risking damage to my other arm, and if so what. My husband wants me to rest but i’m going stir crazy!!

  33. Media Partners says

    Shirley, was this for the other shoulder or did you have to have a do-over for the prior shoulder replacement? How long did you do PT?

  34. I am just recovering from my second total shoulder surgery….in 6 months after the first surgery I was back to full function and am now 11 weeks after the second surgery….cannot say enough about physical therapy and continued proscribed exercises at home…my surgeon was a shoulder specialist which to me made a lot of good difference after noting results from friends who did not have my great recovery. Also those that avoided physical therapy because of the discomfort have never regained full use of their arm again….

  35. Media Partners says

    Lori,

    You certainly seem to be a fighter with all that surgery and being “brought back.” Whether to have surgery is a question only you can answer. Is it for the shoulder of your dominant arm? Is it the shoulder of the arm where you use the cane? Have you asked your doctor if it would help to use a walker to take some of the pressure off your shoulder? Have you checked with the hospital’s social services department to see what they can do to help you while you recover? You’d be surprised what hospitals can do now. What about something like the Visiting Angels that can help you during recovery? Some hospitals have areas you can stay that is similar to assisted living while you heal. They only help you when you need it until you can get around without help. There are also injections that can make the joints more slippery, have you asked about those? It’s a hard decision, but find out as much as you can what you will need after surgery, how you will get help, whether the surgery will make your life better or worse—maybe you won’t be able to lean on that shoulder with your cane? Lots to consider. Good luck.

    We don’t offer advice, just suggestions that you may not know are out there to help you learn more about your health.

  36. Lori Hughe says

    I am 85 yrs old and have been told I need a total shoulder replacement. When I had a knee replacement they lost me but brought me back to life.That was 2 yrs ago. Do you think I’m too old for this surgery.
    My cartilage is gone from arthritis. Would I be better off at my age to just live with it and keep up my excercises and stay on pain medication.
    I have 2 stents after a heart attack 6 yrs. ago. I’m in a dilema and just don’t know what to do. I am a widow and live alone. I have back issues and use a cane for my stability. What would be your opinion. Thank you so much.

  37. Media Partners says

    Mike,

    I feel your pain. 🙂 But in reverse order. I tore the common extensor tendon in my elbow (tennis elbow) on February 20, 2012. After seeing the doctor he put me in PT. Finally he recommended surgery to repair the tendon. I got a second opinion and have been in PT now for 3 months trying to avoid surgery. My elbow is fine, no pain, some strength loss but no pain. HOWEVER, my shoulder and bicep are killing me. Like you, I come off the table when the PT touches it. Remember the song Dem Bones? Well, apparently our nearby joints are compensating for loss of movement in the injured joint. And, doing the PT also works the nearby joints which may have become weak from nonuse with the injury. It is so frustrating how long this has taken, but there is very little blood supply in the ligaments and tendons, so it takes them much longer to heal. I get along fine during the day but nighttime is horrible. I can’t wait for a good night’s sleep without pain. The other issue is the muscles in those areas are so small that it doesn’t take much PT to overwhelm them. My PT calls it “collateral damage.”

  38. I had a partial shoulder replacement done 3/5/12. The morning after my elbow was extremely sore. Now I have been in therapy for 3 mos. and the shoulder seems to be doing very well. However, the elbow is still causing a lot of trouble. When the therapist try to bend my elbow toward my head with my arm at 90 degrees from my body, I about come of the table. It has gotten a little better over the 3 mos. but it still is a problem. Does this happen with shoulder surgeries, or what might it be?

  39. Great Great article…the clearest and comprehensive I’ve seen. Ki am getting shoulder replacement Feruary of 2012… mine is because of a trauma to the shoulder 3 years ago.
    I am an ex teaching tennis professional and would love to continue to teach part time.. any tennis players out there still playing after TSR??.
    -Zivko

  40. How long must you be off work if you have a “desk job: after shoulder replacement surgery

    thanks

    sandy

  41. Wendell Thompson says

    Very informative. I only heard about a reverse replacement the other day. The individual couldn’t explain well enough for me to understand. Now I do. I am glad that I am a good candidate for a straight total replacement as my rotator cuff is in good shape. Only thing is that I was under the impression that I would be ready for tennis in 3 to 4 months (it is my non-dominant shoulder). It sounds like I am too optimistic. I am healthy and serious about rehab though and am hopeful that I can break the curve a little.

  42. Hello, I had shoulder replacement surgery the end of Feb. 2011. I have been doing well except, I can only lift my arm straight out in front of me to the shoulder high. If that makes sense. I’ll get pain or cramp in the upper arm muscle.
    I’ll see the Doc tomorrow and I think there is something very
    wrong. I go to PT and they are “so happy” but I have a job that wants me back. I work as a cashier and I cant hand thing to people like change that not good..

  43. Patricia Peterson says

    Pat
    Thank you for such a clear and easily understood description of shoulder replacement surgery, before and after. Much appreciated as I am contemplating the procedure. Wonderful site.

  44. A person necessarily assist to make severely articles I’d state. That is the first time I frequented your website page and to this point? I amazed with the analysis you made to create this particular put up incredible. Magnificent task!

  45. Will let you know what I’m going to do with the surgery and how things go afterwards. Thanks for the advise, and I will get a ton of answers before

  46. Media Partners says

    Rick,

    I would have a TON of questions for my surgeon if I were you! Did you ask which—either a regular or reverse shoulder replacement—would give more stability to your shoulder? What about doing exercises before surgery to strengthen your shoulder and make recovery faster. What about a walker right after surgery to help take some of the pressure of that shoulder? That certainly is a rock and a hard place. Good luck, let us know what you decide and how you do.

  47. I’m seriously considering a complete shoulder replacement, but am really concerned cause it’s my right shoulder and I depend greatly on using my right arm to use a cane because of major back problems that were never corrected during 4 surgeries which included 1 fusion at Duke University where they did a fusion on the inside of my spine through my stomach and none of my surgeries were successful and really need to use the cane in my right hand to stay active. This I’m sure through the years lead to the early deterioration of my shoulder and now I really feel I’m stuck between that famous “Rock and a Hard Place”

  48. I’ve been receiving lidocaine injections since 2006 for a shoulder injury I received at work. The WC doctor thought it was bursitis. The pain has worsened over the years and became unbearable Sept. 2010 after lifting a 2 lb. bag of fruit at work. The WC doctor took an x-ray on Oct. 1st, 2010, the first since my 2006 injury. Now, I’m told I need a reverse shoulder replacement. I’m a widow and have concerns about being able to perform my work duties after surgery. I’m a kitchen manager in a central kitchen that requires lifting 40 lbs. on a daily basis. Do you think I’ll be able to return to normal work conditions?

  49. Media Partners says

    Thanks for the comment. We work hard to bring information that people can use. As you go through your surgery, if you find things we’ve left out or you wish you had known, let us know. We’ll be glad to update our page. Good luck with your surgery!

  50. Thank you for an excellent background read on my upcoming surgery. By far the best I have seen! Wish I’d had something similar eight years ago when I had a mastectomy! Keep up the good work, and I have bookmarked the page for my husband and helper to read.

  51. Media Partners says

    I’m glad it helped. We are working on an article for hemi shoulder replacement and reverse shoulder replacement. Good luck with your rehab and recovery!

  52. Had the hemi shoulder replacement surgery a month ago. My doctor is very good and did great work on my shoulder.
    Today I am looking for information related to my recovery. Knowing what is happening inside my shoulder will allow me to relate to what the physical therapists are working on, and gives me the information I was looking for to ask questions.
    Just as I was getting frustrated with all the lack of information – I finally found your website!
    Your shoulder pictures and descriptions are exactly what I wanted to find. Thank you

  53. Jim Roberto says

    I was looking for a basic primer and, as such, this was an excellent article. Now I am looking for more information on the PRO’s and CON’s of a “regular” vs a “reverse” replacement procedure and prosthesis

  54. I had total reverse shoulder replacement 2 yrs ago and they used a brachial plaxus nerve block and I now have been experiencing nerve damage on the same side of my face. I have trouble keeping my eye open and a twitching and pulling on my face going back to as far as my ear. Also sometimes I have pain in my teeth on the same side. Could this be from the shot? It’s like I have bells palsy. Sometimes these episodes are worse than others and the area around the teeth and jaw can be very painful.

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