Anatomical Total Shoulder Replacement (Arthroplasty)
A procedure to replace the shoulder joint and restore pain-free mobility
Total shoulder replacement involves replacing the damaged joint surfaces of the shoulder with artificial components, typically made from metal and polyethylene. The goal is to replicate the natural function of the shoulder joint as closely as possible.
Common Reasons for Surgery
- Severe osteoarthritis or rheumatoid arthritis in the shoulder joint.
- Shoulder fractures that have caused irreparable damage to the joint.
- Persistent pain and stiffness that significantly impact daily activities.
Goals of the Procedure:
- Reduce or eliminate chronic shoulder pain.
- Improve shoulder strength, stability, and range of motion.
- Enable patients to return to everyday activities with greater comfort.
Preparation for Surgery
Preparation is key to ensuring the best possible outcomes from shoulder replacement surgery.
Steps in Preparation:
- Pre-Surgical Assessments:
- Dr Ben McGrath will conduct a thorough evaluation, including imaging such as X-rays or MRIs, to confirm the extent of joint damage and plan the surgery.
- Pre-Operative Instructions:
- Follow fasting requirements as instructed.
- Discuss medications with Dr McGrath to determine if any should be adjusted or paused before surgery.
- Optimising Health:
- Engaging in gentle shoulder exercises, ceasing smoking, and managing body weight may be recommended to improve surgical outcomes.
What Happens During the Surgery?
Total shoulder replacement surgery is typically performed under general anaesthesia and may take 2–3 hours.
Surgical Steps:
- Anaesthesia:
- General anaesthesia is used to ensure patient comfort.
- Procedure:
- An incision is made at the front of the shoulder.
- Damaged cartilage and bone are removed.
- The joint is reconstructed using prosthetic components: a metal ball to replace the humeral head and a polyethylene socket to replace the glenoid.
- Completion:
- The incision is closed, and a sterile dressing is applied.
Understanding the Risks
While total shoulder replacement is generally safe, it carries some risks, as with any surgical procedure.
Common Risks:
- Post-operative pain and swelling.
- Temporary stiffness or reduced mobility.
Rare but Serious Risks:
- Infection at the surgical site.
- Implant loosening or dislocation.
- Damage to surrounding nerves or blood vessels.
Dr McGrath’s team takes extensive measures to minimise these risks and ensure a safe surgical experience.
What to Expect After Surgery
Immediate Post-Operative Care:
- Patients typically stay in hospital for 1–3 days.
- Pain management will include prescribed medications and ice application.
- The arm will be placed in a sling to protect the shoulder during the early recovery phase.
Discharge Instructions:
- Keep the surgical site clean and dry.
- Avoid activities that put strain on the shoulder, following all movement restrictions.
Rehabilitation and Recovery
Recovery from shoulder replacement surgery involves a structured rehabilitation program to rebuild strength and mobility.
Recovery Timeline:
- First 6 Weeks:
- Use of a sling to protect the joint.
- Gradual introduction of passive range-of-motion exercises guided by a physiotherapist.
- Weeks 6–12:
- Progress to active shoulder movements and strengthening exercises.
- Months 3–6:
- Full return to daily activities, with clearance for sports or heavier tasks typically occurring after 6 months.
Restrictions During Recovery:
- Avoid lifting heavy objects or overhead movements early in recovery.
- Follow physiotherapy recommendations to optimise outcomes.
Long-Term Outcomes
Total shoulder replacement surgery may provide significant improvements in shoulder function and pain relief.
Expected Benefits:
- Improved shoulder strength and mobility.
- Relief from chronic shoulder pain.
- Enhanced ability to perform daily tasks and recreational activities.
Maintenance of Results:
- Continue strengthening exercises as recommended by your physiotherapist.
- Attend follow-up appointments with Dr McGrath to monitor joint health and prosthesis function.