Shoulder Replacement Surgery
A shoulder replacement, also known as shoulder arthroplasty, is a surgical procedure to repair your shoulder joint if it’s been damaged or worn away, usually by arthritis. Some or all of your shoulder joint is replaced with artificial parts made of metal and plastic.
The shoulder is a ball and socket-type joint made up of the glenoid (socket) and the humerus (ball). When arthritis affects the shoulder it causes the lining of these joint surfaces to wear, causing pain and stiffness. During a total shoulder replacement, both the head of the humerus and the socket are replaced with artificial parts so that the joint can move smoothly again. The results are the alleviation of pain and a greater range of movement, giving the patient improved overall quality of life.
The two most common types of shoulder replacement are anatomic and reverse. An anatomic replacement changes the ball and socket for metal and plastic and a reverse shoulder replacement switches the position of the ball with the socket. A reverse shoulder replacement may be recommended to provide more strength to the joint if there is damage to the rotator cuff, the group of muscles and tendons that stabilise the shoulder joint and control movement.
Diagnosis and suitability for a shoulder replacement
Your suitability for this surgery will be assessed by your consultant. Severe pain in the shoulder and difficulty sleeping are indicative of shoulder arthritis but an X-ray will confirm a diagnosis. An MRI scan will show the condition of the rotator cuff, which will determine if an anatomic or reverse shoulder is the best option.
What does the surgery involve?
Shoulder replacement surgery will be performed under a general anaesthetic. A nerve root injection will also be given to eliminate all pain immediately after surgery.
An incision is made at the front of the shoulder and the deltoid and pectoral muscles separated to gain access to the shoulder joint. The worn out damaged surfaces of the humerus and glenoid, the socket, are removed and the artificial ball and socket are positioned and secured with a combination of cement and screws. These artificial replacements mimic the original structure of your shoulder.
For a reverse shoulder replacement, the ball and the socket of the joint are switched around so the ball is attached to your shoulder blade, where your socket was before, and a new socket is attached to the top of the humerus. The new ball and socket each have a stem which are anchored into your bones with cement and screws.
A partial shoulder replacement, where only the ball at the top of your humerus is replaced, is also an option. The new ball works with your existing socket.
In all cases, the implants have a special coating which encourages bone to grow into the surface of the implant to make sure that it is secure.
The shoulder replacement surgery will take 2 – 3 hours. Once surgery is over the incision is closed with stitches and dressing and sling will be applied.
How long will it take to recover from this surgery?
You will need to stay in hospital at least 1 night following shoulder replacement surgery. You will soon come around from the general anaesthetic bit the nerve block will last longer so you won’t regain feeling in your arm immediately. When the nerve block begins to wear off you will experience a tingling sensation and within an hour full feeling will return. You will be offered pain relief if you need it. Pain due to arthritis will be alleviated, but pain from the surgery can last up to 6 weeks. You will be prescribed pain medication for the first few weeks.
While in hospital a physiotherapist will assess you and provide an exercise plan to follow at home to help you rebuild your strength, minimise stiffness and restore full range of motion in the shoulder joint. It’s important to continue to do the exercises your physiotherapist recommends. These will help your shoulder to heal and may help you to recover more quickly.
You will need to keep your arm in a sling for 4 – 6 weeks following surgery to ensure the joint is protected, allowing it to heal and preventing dislocation.
Within a few weeks of your shoulder replacement surgery you will be able to complete light tasks but anything strenuous should be avoided for 6 weeks. Full range of motion is usually restored by 3 months. Heavy lifting and sports should be avoided for at least 6 months.
At your follow up appointment you consultant will be able to advise when you can return to driving and work. Everyone is different but, as a guide, you may be able to drive again by about four weeks after the operation, and you are likely to be able to return to work at this point as long as your job is not manual.
Revision Shoulder Replacement
The success rate for shoulder replacement surgery is very good, with 85-90% of shoulder replacements still working ten years after implantation. In the long term however, revision shoulder replacement surgery may be needed. This surgery involves replacing your artificial shoulder joint if it has become loose or worn out. It is often a more complex procedure than the original surgery because the existing prosthesis will need to be removed and it may be necessary to repair the bone before fixing the new prosthesis.
Shoulder Replacement Surgery Explained
At One Hatfield Hospital in Hertfordshire, we can book you in to see a specialist Orthopaedic Shoulder Surgeon for an initial consultation, usually within 48 hours.
You can use your private medical insurance or pay for your Shoulder Replacement Surgery treatment. We offer competitive, fixed price packages as well as the ability to spread your cost with the option of 0% finance. If you are using your health insurance please do contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.
Why One Healthcare
- Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
- Fast access to diagnostics including MRI, Xray and Ultrasound
- Private, spacious, en-suite rooms
- Specialist Physiotherapy and nursing teams
- Little or no waiting time
- ‘Ultra clean air’ theatres
- Freshly prepared food
- Calm, dignified experience
Mr Rajeev Sharma
Consultant Orthopaedic Surgeon - Upper Limb Surgery (Shoulder, Elbow, Wrist and Hand)
One Hatfield Hospital