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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.
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?
As the wise old orthopedic surgeon once said, "The time it takes
to do the operation is the time it takes to do it right!" Usually
about an hour and a half gives us the time to position you for the surgery,
wash your shoulder and prepare the skin for surgery, wash your shoulder
and prepare the skin for surgery, do the operation, wake you up, and move
you to the recovery room. You can anticipate being in the recovery room
for an hour before going back to your room. Ask your family to wait in
the surgical waiting room, and I will be looking forward to telling them
about your total shoulder replacement.
HOW LONG WILL I BE IN THE HOSPITAL?
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 ‘BOUT 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.
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.
See our animated shoulder anatomy.
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