If you have considered or perhaps scheduled shoulder replacement surgery with your orthopedic surgeon, chances are you have been struggling with shoulder pain and discomfort for a long time.
What Happens During a Joint Replacement?
To briefly describe a joint replacement procedure, your surgeon will carefully open your painful shoulder joint and remove the worn surfaces of cartilage and bone.
These surfaces will be replaced with new low-friction surfaces, likely consisting of a highly pure metallic surface on one side and a special plastic polymer on the other.
These new surfaces will remove the most significant source of your pain: the worn and torn joint surfaces, which after years of arthritis are like two pieces of stone rubbing together.
With the new gliding surfaces in place, specially customized to suit the size of your bones, your existing muscles, tendons, and ligaments can be used more freely. This restores comfortable motion and improves function.
Like most joint replacement procedures, it will likely be followed by a short overnight stay in the hospital to ensure pain is controlled and to monitor your vital signs. However, it is also possible that you are a candidate for discharge home on the day of surgery.
What Type of Anesthesia Is Used During a Joint Replacement?
Either way, specially trained anesthesia doctors will evaluate you and form a plan to keep you comfortable both during and after your procedure. This usually involves a nerve block, where special numbing medication is applied to the nerves that go to the shoulder. This numbs the operated area during surgery and immediately thereafter.
It is important to keep in mind that the nerves that supply the rest of your arm, even to the fingertips, may also need to be numbed. This nerve block usually lasts for about 12 hours on average.
However, other medications will also be administered to make you sleep and relax throughout the procedure. Because these medications are so effective, you will likely not remember the first few hours after the procedure as you slowly awaken in the recovery room. There, specially trained nurses will monitor your vital signs and ensure you remain stable.
Important Postsurgical Information
After he or she is finished with your procedure, the surgeon will place a clean, sterile dressing over the incision. It is important to keep this incision clean and dry and maintain it in place for as long as your surgeon instructs.
Because the dressing was applied in a “sterile” environment, the underside of the dressing remains very clean and prevents bacteria from the “non-sterile” environment outside the operating room from entering your wound before it heals. You will likely be able to shower two to three days after the procedure, however, you should consult your surgeon for exact instructions.
As a general rule, patients undergoing shoulder replacement surgery will be immobilized in a sling after surgery. Each surgeon may have different instructions on how long the sling will be worn, depending on the exact type of surgery you undergo and many other factors.
It is very important to follow your surgeon’s instructions exactly, because moving your shoulder too early, even if you feel comfortable to do so, can cause serious complications and interfere with the healing process.
But being in a sling doesn’t mean staying in bed all day. In fact, it is crucially important that you are up and walking as soon as you are able and to carefully remove your sling a few times a day to work on your hand, wrist, and elbow motion (while keeping your shoulder still).
Gentle physical activity:
- Encourages healthy blood flow throughout your body
- Lowers the risk of blood clots
- Prevents weakening of other muscle groups
- Releases mood-elevating hormones
- Promotes a sense of well-being
- Provides relaxation
Will I Need Pain Medication After Shoulder Replacement Surgery?
After shoulder replacement surgery, most patients are able to manage normal postoperative pain and discomfort with regularly scheduled over-the-counter medications like Tylenol and Ibuprofen.
In the event that these medications, along with the regular application of ice in the first few days after surgery, do not bring discomfort to manageable levels, a stronger narcotic pain medication will likely be prescribed by your surgeon.
Although these medications are very effective at altering your brain’s response to pain signals, they have no anti-inflammatory effects, can be habit-forming, and have multiple undesirable side effects such as sleepiness, constipation, and nausea. These medications will most likely not be necessary after three or four days after surgery.
When Can I Return to Normal Activity After a Shoulder Replacement?
A postoperative visit will likely be scheduled with your surgeon around two weeks after surgery. The purpose of this visit is to X-ray your implant to ensure everything remains in the correct position, as well as to ensure that no complications have arisen. The surgeon will examine the surgical wound and possibly remove sutures.
Depending on your surgery and the preferences of your surgeon, a very gradual return to motion will begin. Usually this begins with “passive” exercises, meaning gentle movement of the replaced joint, but without using the muscles in and around the replaced joint.
An example of this is taking hold of your right hand with your left hand, and using the strength in your left arm to raise your right arm while keeping the right arm limp.
Over the following weeks and months, this will progress to “active” motion, slowly re-building the strength of the muscles around your replaced joint. This may include simple waist-level activities around the house and using the arm for things like hygiene and dressing.
Finally, it is very important to keep in mind that although the arthritis is gone and you have a new freely-gliding joint surface, the overall healing process isn’t fully complete until one year after the surgery! Most patients feel significant relief within weeks, but as with most things in life, patience is the key.
We Want to Relieve Your Shoulder Pain
Is constant shoulder pain keeping you from the activities you love? Does constant arthritis discomfort interfere with your day-to-day life?
You don’t have to put up with the pain. Contact us for an appointment to see how we can help you.