Body > Common Shoulder Surgeries > Total Shoulder Replacement

Total Shoulder Replacement

This surgery, is usually performed under a combination of general anaesthetic and a nerve block. You will be required to stay in hospital for 1-3 days after your operation.

A shoulder replacement is performed to remove labrum and bone that has become rough, torn or overgrown, often due to Osteoarthritis. This surgery is also performed on people after a significant shoulder injury, like a humerus fracture, if the shoulder joint no longer functions properly.  It is a surgery used predominantly for the relief of pain.

A large diagonal incision is made at the front of the shoulder. Through this incision the surgeon can dislocate the old shoulder, and cut out the damaged end of the ball, and smooth out the roughened socket. As the rotator cuff tendons are often damaged in the older shoulder, and no longer provide stability to the joint, a reverse total shoulder replacement is performed to give more stability. The ball (humerus) and the socket (glenoid) are reversed, with a metal ball fixed into the glenoid, and a stem and socket fitted into the humerus. These can be held in place by screws or cement. The two components are then placed back together, and the muscles and skin incisions stitched up. 

The incisions are dressed, and the arm is placed in a special sling with a cushion under the arm to protect the shoulder.  The sling may need to be used all the time for 2-6 weeks.  Gentle exercises are started in the first few days or weeks after your operation, guided by your physiotherapist. 

Precautions

• Don’t put your hand behind your back, even to tuck in your shirt, or put something in your back pocket. This can cause the shoulder to dislocate.
• Don’t lift your arm without assistance otherwise the repair can be compromised.
• Don’t sleep on your operated side, and when getting in or out of bed, always roll towards the non-operated side.

Exercises

• After your shoulder operation it is very important to perform exercises to regain your mobility, and later strength.
• Don’t use the muscles in the operated shoulder to raise the arm away from your side, even in the sling.
• Only perform exercises taught to you by your physiotherapist or surgeon.
• Exercises should be performed 3-5 times a day.  It may be helpful to take pain medication 30-40 minutes prior to exercise (as prescribed by your doctor).

Swelling

• You may have considerable swelling around your shoulder after surgery.
• Apply ice for a maximum of 20 minutes following exercises or as required.
• Ice (crushed, cubes, frozen peas, gel pack etc.) should be wrapped in a towel and placed directly on the shoulder, over the waterproof dressing.

Pain

• Immediately after your surgery, pain at rest and with movement is expected.
• Take your medication and use ice regularly to keep your pain mild-moderate (<4/10).
• Many people develop pain around the neck, upper back and down the arm which is normal, but if you are concerned please call your physiotherapist.
• If you develop worsening tingling or numbness, please call your physiotherapist.

Sling

• The sling is for protection for the first 2-6 weeks after the operation.
• Ensure your elbow is in the corner of the sling, and hand supported inside the sling.
• Your arm should rest comfortably in the sling, with the entire weight of the arm supported and with your hand at the level of your chest.
• Wear the sling both day and night (including sleeping).
• Only remove the sling for showering, and when doing the prescribed exercises.

Driving

• No driving for 4-6 weeks to ensure that the repair site heals well.
• Await instructions from your surgeon or physiotherapist to commence driving.