Shoulder Replacement
Description: Shoulder replacement surgery, also known as shoulder arthroplasty, is a procedure to replace the damaged parts of the shoulder joint with artificial components. This surgery is typically performed to relieve pain and restore function in patients with severe arthritis, fractures, or other degenerative conditions. There are several types of shoulder replacement procedures, each tailored to the specific needs of the patient. Here is a detailed overview:
Total Shoulder Replacement
Indications:
- Osteoarthritis
- Rheumatoid arthritis
Procedure:
- Incision: A small incision is made over the front of the shoulder to access the joint.
- Preparation: The damaged humeral head (ball) and glenoid (socket) are prepared by removing any diseased bone and cartilage.
- Implant Placement: A metal ball attached to a stem is inserted into the humerus, and a plastic socket is placed in the glenoid.
- Closure: The incision is closed with sutures or staples, and the shoulder is bandaged..
Reverse Total Shoulder Replacement
Indications:
- Severe rotator cuff tears with arthritis
- Complex fractures
- Revision of failed shoulder replacement
Procedure:
- Incision: A small incision is made over the front of the shoulder to access the joint.
- Preparation: The damaged humeral head and glenoid are prepared by removing any diseased bone and cartilage.
- Implant Placement: In this procedure, the normal ball-and-socket structure is reversed. A metal ball is attached to the glenoid, and a plastic socket is attached to the humerus.
- Closure: The incision is closed with sutures or staples, and the shoulder is bandaged.
Recovery from shoulder replacement surgery involves a structured rehabilitation program that spans several months. The goals are to restore shoulder range of motion, strength, and stability, and to gradually return to normal activities.
Immediate Postoperative Phase (Weeks 1-2):
- Focus on reducing swelling and pain.
- Gentle range-of-motion exercises.
- Sling usage to immobilize the shoulder.
Early Rehabilitation Phase (Weeks 3-6):
- Increase range-of-motion exercises.
- Begin strengthening exercises, focusing on the rotator cuff and shoulder muscles.
- Gradual increase in weight-bearing activities.
Intermediate Rehabilitation Phase (Weeks 7-12):
- Continue strengthening exercises.
- Introduce balance and proprioception exercises.
- Gradual return to low-impact activities.
Advanced Rehabilitation Phase (Months 3-6):
- Focus on advanced strength and functional training.
- Gradual return to sports-specific activities.
- Continue working on agility and coordination.
Return to Sports (Months 6-12):
- Full return to sports and high-impact activities.
- Ongoing strength and conditioning to prevent re-injury.
This question varies a lot on what you do, and any accommodations that can be made for you at work and at home. Most importantly is depends on you – your expectations, drive and recovery are all variable. Most “desk” type jobs can be resumed around 8-12 weeks later, sooner in some cases. Most physical jobs will need a stronger recovery, typically 3-4 months.
You may drive when:
1) You are no longer taking narcotic pain medication
2) You have full power and function to engage in emergency braking of your car if necessary.
This usually takes a minimum of 6 weeks.
Once your shoulder replacement has healed, you can resume all day-to-day activities. For recreational activities, you may return to skating, skiing, light weight lifting, swimming, bowling, golfing, tennis, squash, biking, and using an elliptical trainer. The only restriction is on high-impact activities is that you can’t lift a weight over your shoulders that weights over 20 pounds. While there is no direct medical evidence that these activities cause early implant failure, they generate very high joint reactive forces, which are believed to potentially lead to earlier wear of the implant.
Ideally, flying and long-distance travel should be postponed until six weeks after surgery. Short flights and travel can be undertaken 1-2 days post-surgery.
In summary, if you can delay travel for the first six weeks, you will likely enjoy your trip more. Short flights, especially those necessary for returning home after surgery, should not be taken before 1-2 days.
