Shoulders are very important to our daily functioning, and when they hurt, our quality of life becomes significantly impaired. Sometimes, if you broke your arm or tore your shoulder tissues very badly, the only way to relieve the pain and regain smoothness of motion is to replace the shoulder joint entirely. People call this procedure a shoulder arthroplasty.
The General Idea
Arthroplasty is a type of surgery where a dysfunctional joint is realigned or reconstructed. In the case of shoulder arthroplasty, the joint is replaced completely with a plastic socket and a metal ball.
There are a few instances when a doctor would recommend this surgery: It is used when an injury tears or damages the tissues in the shoulder, a bone breaks badly close to the shoulder, rheumatoid arthritis wears away the joint, or a tumor grows in or around a shoulder.
Shoulder arthroplasty can be called endoprosthetic shoulder replacement and total shoulder arthroplasty, too. Whatever your doctor calls it, its goal is to relieve the pain and return smooth movement.
This is what will happen when you doctor suggests shoulder arthroplasty: You make an appointment for the surgery 2 weeks from then. The doctor will suggest you stop smoking and taking medicines that impede blood clotting such as aspirin.
On the day of the surgery, you will have to stop eating for 6 to 12 hours beforehand. The nurses will administer anesthesia and a sedative to help you relax. Once you are numb, the doctor will make a cut over your shoulder joint. Then the doctor will remove the top of the upper arm bone, called the humerus. The hospital will have a new head and stem to replace the top of the humerus, and they will cement it in place. The surgeons will also smooth out the socket part of the shoulder joint and cement a new socket in that spot. The entire procedure should only take 1 to 3 hours.
After this, the doctor will suture the cut closed and bandage it. The cut might need a tube to drain away fluid, but you will only have it as long as strictly necessary.
There are partial shoulder arthroplasties. In those procedures only one part of the joint gets replaced. The procedure is substantially the same.
Recovery and Rehabilitation
The hospital is unlikely to keep you long after you had your surgery: just 1 to 3 days. You might receive some physical therapy there to learn how to move your shoulder. The hospital might have you on a pulley that brings your shoulder through a 90 degree arc of flexion and a 45 degree arc of rotation. They would prefer to let you out once you can raise your arm 140 degrees.
When you go home, your arm will be in a sling. It will have to be in a sling for 2 to 6 weeks. It takes about 3 months to start regaining your strength, and around 4 to 6 months to completely recover.
During this time, you will do plenty of gentle exercises to slowly add strength and range of motion. The hospital will give you a paper instructing you on the exercises you must do to recover, and you must follow the instructions exactly or you will re-injure your arm. You can stop exercises if your muscles get sore, but you have to keep moving your shoulder to keep your flexibility. It may take as much as 2 years of rehabilitative therapy to gain maximum movement, but you should be able to use your shoulders without pain after the 6 months.
You can return to your normal activities, including sports, but you may want to be careful. The new joint generally lasts about 10 years with normal use, but it might not last as long if you put a lot of strain on it. Because of the limited lifespan of the joint, doctors prefer to perform the procedure on older patients.
Shoulder arthroplasty is a big procedure with a long rehabilitation time. If your work-related injury leads to a shoulder replacement, you will need all the workman’s compensation coming to you. If the insurance company tries to get out of helping you, contact us. The law office of Joshua Borken works with shoulder arthroplasty patients frequently and will get you all the compensation you need.