Shoulder Replacement Surgery

Types of Shoulder Replacements

Partial Shoulder Replacement Surgery

Also called a hemiarthroplasty, is a surgical procedure in which only part of the shoulder joint is replaced. It is typically done when only the ball of the shoulder joint is damaged, while the socket remains intact and healthy.

A partial shoulder replacement is often recommended for:
Severe fractures of the humeral head (common in older adults), Osteoarthritis or rheumatoid arthritis affecting only the humeral head, Avascular necrosis (loss of blood supply to the humeral head) and Previous failed shoulder surgery.

Procedure Overview

– Anaesthesia: General anaesthesia or regional nerve block (numbs the shoulder).
– Incision: A 4-6 inch incision is made in the front of the shoulder.
– Bone Preparation: The damaged humeral head is removed.
– Implant Placement: A metal implant replaces the humeral head.
– Closure: The incision is closed with sutures or staples.

Recovery & Rehabilitation

– Hospital stays: 2-3 days
– Sling use: 4-6 weeks
– Physical therapy: Begins early to regain motion and strength
– Full recovery: 3-6 months, depending on the person’s condition and adherence to rehab

Benefits

– Pain relief – Significant reduction in pain.
– Improved shoulder function – Better mobility than before surgery.
– Long-lasting results – Implants can last 10–20 years.

Risks

– Infection 
– Implant loosening or failure (more common if overused)
– Nerve or blood vessel injury 
– Stiffness or limited motion (not commitment to physical therapy)
– It may not fully restore strength if rotator cuff damage is present.

Home Remedies

– Ice therapy: Apply ice packs for 20 minutes at a time, every 2–3 hours to reduce swelling.
– Elevate your arm: Keep it supported with pillows when resting.
– Relaxation techniques: Deep breathing, meditation, or gentle music can help manage discomfort.
– Avoid heavy lifting, sudden jerking motions, or pushing exercises (like push-ups) for at least 3–6 months!

Lifestyle Adjustments for a Smooth Recovery

– Dressing: Use loose, button-up shirts. Dress the operated arm first.
– Sleeping: Sleep in a recliner or with pillows to keep your shoulder supported.
– Driving: Usually allowed after 6 weeks (once you can move your arm comfortably).

Things to Avoid

– Overusing the arm too soon – Can cause implant loosening.
– Lifting anything heavier than 5 lbs – Wait until cleared by your doctor.
– Sleeping on the operated side – Can cause pain and swelling.

Reverse Shoulder Replacement Surgery

Also called reverse total shoulder arthroplasty is a surgical procedure used to treat severe shoulder arthritis, massive rotator cuff tears, or complex fractures. It’s called “reverse” because it switches the ball-and-socket anatomy of the shoulder. In a normal shoulder, the ball is at the top of the arm bone, and the socket is part of the shoulder blade. In a reverse shoulder replacement, the ball is attached to the shoulder blade, and the socket is placed on top of the arm bone.

Procedure Overview

– The reverse design relies on the deltoid muscle instead of the damaged rotator cuff to lift and move the arm, improving function and reducing pain.
– Recommended for:
– Massive rotator cuff tears that cannot be repaired
– Cuff tear arthropathy (arthritis due to long-term rotator cuff damage)
– Severe shoulder arthritis with poor function
– Complex fractures of the upper arm bone, Failed previous shoulder replacement.

Recovery & Rehabilitation

– Hospital stays: Usually 2-3 days
– Sling use: 4-6 weeks
– Physiotherapy: Starts after surgery and continues for months
– Full recovery: 4-6 months, but improvements continue up to a year

How Much Function Will I Regain?

– Most people regain shoulder motion for daily activities like eating, dressing, and reaching waist-high or slightly above.
– Overhead movements and heavy lifting may still be limited, especially compared to a healthy shoulder.
– Driving is usually possible by 6-8 weeks post-op.
– Full recovery takes about 6-12 months, but improvements can continue beyond that.

Will My Shoulder Feel Normal?

– No pain, but not completely natural—most patients feel stiffness or mild weakness.
– The shoulder will feel different because of the reversed ball-and-socket design.

How Long Does the Implant Last?

– Reverse shoulder replacements typically last 10-20 years.
– Implant longevity depends on activity level, bone quality, and avoiding excessive strain.

Activity Restrictions

OK to do:
– Light household tasks, walking, stationary cycling.
– Golf, swimming, or low-impact exercise (after full recovery).

Avoid:
– Heavy lifting to protect the implant.
– High-impact sports (tennis, basketball, contact sports).
– Repetitive overhead movements (like heavy painting, construction work).