What is shoulder replacement surgery?

In shoulder replacement surgery, a doctor removes the end of the upper arm bone. Often he or she also takes out the end of the shoulder bone. The ends are replaced with plastic or metal pieces.

To do this surgery, the doctor makes a cut about 15 centimetres long on your shoulder. This cut is called an incision. The incision leaves a scar that usually fades with time.

You will probably stay in the hospital for 2 or 3 days after your surgery. Your rehabilitation program (rehab) starts when you are in the hospital. You will do this rehab for about 3 months or longer.

It takes at least 6 months to return to full activity. But if you can avoid certain arm movements like lifting, you may be able to go back to work in as soon as 2 to 3 weeks.

After surgery and rehab, you probably will have much less pain than before. And you should be able to return to your usual activities. But your doctor may advise you not to do activities that put stress on that shoulder, such as weight lifting or tennis.

In the future, make sure to let all health professionals know about your artificial shoulder. You may have to take antibiotics before you have dental work or a medical procedure. This helps reduce the chance that your new shoulder will get infected.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your surgery.

Preparing for surgery

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.

Going home

• Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
• You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.
• Get extra help at home. This is most important if you live alone or care for another person.
• A physiotherapist will show you how to use a pulley device. This will help you lift your arm. It will also keep your shoulder flexible. You won't be allowed to use your shoulder muscles. So you will need to use the pulley to move your shoulder.
• You will wear a sling at night. It's also a good idea to put a small stack of folded sheets or towels under your upper arm when you are in bed. This can keep your arm from dropping too far back. Your arm should be next to your body or in front of it for several weeks. Try to do this at all times, even when you sleep.
• Don't lift anything with the affected arm for 6 weeks.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.