Shoulder replacement surgery

Shoulder replacement surgery involves replacing the damaged shoulder joint with a new, artificial metal ball. The socket is then covered with a plastic surface which the artificial joint fits into. 

After shoulder replacement surgery, you will regain normal movement in your shoulder and a new shoulder joint will last for at least ten years, after which it may need to be replaced again.

The shoulder has four individual joints. The largest of these joints is a "ball and socket". The ball is formed by the upper arm bone fitting into the socket which is part of the shoulder blade.

Osteoarthritis, a condition that causes joints to become stiff and painful, is one of the most common reasons why patients need shoulder replacement surgery. 

Shoulder replacement surgery is carried out in hospital under general anaesthetic with local anaesthetic also used to numb the nerves in the whole of the arm. The surgery usually takes around two and a half hours.

You will not be able to eat for eight hours prior to your shoulder surgery although you will be able to drink small amounts of water up to four hours before. You would normally be admitted the evening before the operation and normal checks will be carried out.

An incision is made over the front of your shoulder and the outer layer of muscles at the front of the shoulder are separated, to expose the deep layer of muscles, the rotator cuff, that directly surround the joint. These muscles and the very tight ligaments and capsule that surround the joint are released to expose the joint.

The surfaces of the bone are then carefully prepared to accept the components of the new shoulder. Sometimes the ball of the socket is resurfaced with a metal hemisphere and sometimes a more conventional shoulder replacement with a stem that passes down the inside of the arm is required. The surface of the socket will then be inspected, cleaned and, if necessary, resurfaced with plastic.

At this stage, a careful assessment of your shoulder is made using a variety of different sized components. Once the correct ones have been selected they are fixed onto the bones. Sometimes cement is used but often the shoulder replacement is designed to grow into your own bones. The muscles and ligaments are then carefully stitched back into place.

Shoulder replacement is closed with stitching the incision which needs to be removed after two weeks.

You are likely to stay in hospital for two to four days after shoulder replacement surgery and your arm will be in a specially designed shoulder sling with the wound covered by waterproof dressing. Exercises and physiotherapy will start the day after the surgery and you will be taught all you need to know for the first couple of weeks of recovery before you leave the hospital.

Your sling is likely to be used for four weeks though this may vary by patient. You will be using your hand and arm but will have difficulty with many day to day activities. Most people can start driving again at around six to eight weeks and should have regained good use of the shoulder by then.

Exercises will continue for many months to gain the maximum benefit in term of movement and recovery of strength and power.

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Circle Health, 32 Welbeck St, Marylebone, London W1G 8EU