Saturday, April 13, 2024

Recovery For Shoulder Replacement Surgery

What Is The Most Painful Shoulder Surgery

Recovering at Home After Total Shoulder Replacement Surgery

Pain is perceived and experienced differently by every individual making it difficult to definitively state which surgery is most painful. It is important to recognize that pain post surgery is normal but is not something to be fearful of. Pain is the bodys way of recognizing there is some sort of an issue, and a physical therapist can help you with pain relief.

Tips For Reverse Shoulder Replacement Rehab

Total shoulder replacement surgery helps to reduce pain and restore function and range of motion for people who suffer from painful shoulder arthritis. The surgery has a high success rate, but it doesnt provide sufficient relief for those who have developed cuff tear arthropathy, a degenerative arthritis of the shoulder resulting from a large rotator cuff tear. A conventional shoulder replacement is designed to work only if the rotator cuff tendons are intact, but for individuals with cuff tear arthropathy, those muscles no longer function properly. A reverse shoulder replacement is a better option for those with cuff tear arthropathy because it relies on the deltoid muscle instead of the rotator cuff to power the arm. Like any joint replacement surgery, rehabilitation is a key to the success of the reverse shoulder replacement.

In Reverse Shoulder Replacements

The components are still metal and plastic, but reversed: The metal ball is attached to the patient’s existing socket, and a new plastic socket is attached to the patient’s upper humerus, which formerly included the natural ball of the anatomic shoulder.

The stem is designed to be cementless to promote the ingrowth of bone into the prosthesis. The plastic socket also features a metal peg that allows the patient’s natural bone to grow into the implant. The Comprehensive Reverse Shoulder System , also designed by HSS surgeons, is entirely cementless. Both sides of the joint feature the ability for natural bone to grow into, and become integrated with the implant.

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What Are The Benefits Of Undergoing Shoulder Replacement Surgery

Our goal is for you to experience the following benefits after having shoulder replacement surgery:

  • Shoulder pain relief
  • Restored range of motion in the shoulder
  • Improved shoulder strength and balance
  • Improved shoulder stability
  • Ability to return to normal activities
  • Access to a multidisciplinary network of physicians
  • High quality care for simple and complex joint conditions

How Does Your Shoulder Work

Total Shoulder Joint Replacement Surgery

Similar to the hip joint, your shoulder is a large ball and socket joint. It can rotate through a greater range of motion than any other joint in your body. The shoulder joint is made up of bones, tendons, muscles and ligaments which hold the shoulder in place and allows for its movement. Bones of the shoulder joint include the Clavicle , Scapula and Humerus .

Your clavicle connects with the shoulder blade at the acromioclavicular joint, or A.C. joint. The clavicle attaches your shoulder to your rib cage and holds it out and away from your body. The rounded head of the humerus, or upper arm bone, rests against the socket in the shoulder blade. The surfaces of the bones where they touch are covered by a smooth substance called cartilage that protects your bones and enables them to glide and move easily. The muscles and tendons that surround the shoulder provide stability and support. A thin, smooth tissue called the synovial membrane covers all remaining surfaces inside the shoulder joint. In a healthy shoulder, this membrane makes a small amount of fluid that lubricates your cartilage and eliminates almost any friction in your shoulder.

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Surgical Steps Of A Traditional Shoulder Replacement

A traditional shoulder replacement surgery is composed of the following six basic steps:

  • The surgeon separates the deltoid and pectoral muscles to access the shoulder in a largely nerve-free area .
  • The shoulder is opened by cutting one of the front muscles of the rotator cuff, which covers the shoulder. This âopens the doorâ to allow the surgeon to view and manipulate the arthritic parts of the shoulder ball and socket.
  • The arthritic sections of the joint are removed.
  • The implant socket, ball and stem components are inserted. The metal ball component is attached to the stem, which extends down inside the patientâs humerus.
  • The incision of the rotator cuff muscle is closed and stitched.
  • The external incision is cleaned and stitched, and a bandage applied as a temporary covering.
  • How Do I Prepare For Shoulder Replacement Surgery What Happens Before The Procedure

    Unless there is an emergency, your surgery will be scheduled in advance. Knowing the date of your operation, you will have enough time to prepare and plan for any special help you might need following discharge from the hospital. It is important to have a partner to assist you with your home exercises following discharge. Your partner should accompany you to physical therapy at least once or twice during your hospital stay. Shoulder replacement can be done as an outpatient procedure but on average, you will be staying one night in the hospital after surgery to make sure your pain is controlled and you are medically stable before leaving the hospital.

    A series of pre-operative tests will be scheduled one to two weeks before surgery. They usually include: some blood tests, an electrocardiogram that evaluates the electrical activity of your heart and a visit with a healthcare provider to make sure you are medically cleared to undergo surgery. Some medications may be discontinued because they will complicate surgery and other medications you may need to continue. You should discontinue use of any anti-inflammatory medication, including aspirin, one week before surgery unless instructed otherwise. You will be given instructions regarding your daily medications in this visit.

    You will be transported to surgery on a cart. Different hospital staff will be asking your name, verifying your identification bracelet and asking you which shoulder will be operated on, right or left.

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    What Causes The Need For Shoulder Replacement Surgery

    In most cases, arthritis and inflammation compromise the cartilage or the surrounding bone tissues. This can in turn cause a deformation of the bone tissues, including the ball and socket of the joint and possibly the nearby AC joint. In the case of osteoarthritis in the AC joint a distal clavicle resection might be able to alleviate symptoms. For a significant problem in the ball and socket of the shoulder joint, a total shoulder placement surgery may be needed.

    Also known as complete shoulder arthroplasty, the procedure calls for removing a modest portion of the shoulder joint. It is then replaced by artificial implants that will eventually restore the full range of rotation as well as significantly reduce discomfort in the joint.

    Though other things can lead to a need for a complete shoulder replacement. This includes severe fractures from an automobile accident or sports injury, as well as bone deformation from inflammatory arthritis.

    Improved Mobility And Function

    Shoulder Replacement, surgery and recovery

    Physical therapy is a critical part of recovery after a shoulder replacement surgery. Before surgery, a physical therapist can help you improve your shoulder and upper back movement to keep your shoulder as strong and mobile as possible until the time of surgery.

    After surgery, a hospital physical therapist will educate you about what precautions to take when you go home and what movements to avoid during the initial healing phase. They also will teach you how to manage your affected arm and to get in and out of bed.

    After discharge, continuing physical therapy is essential to ensure your safe recovery. Your physical therapist will work with you to progress your exercises at the right times in the healing process. They will help you get back your range of motion, improve your strength and function, and eventually help you get back to your everyday activities, job, or sport.

    Be sure to tell your physical therapist your goals, so both of you can focus on what is important to you.

    Physical therapists are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.

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    Dont Miss This Simple Breakdown Of Recovery Time For Total Shoulder Replacement Surgery

    Here at Rothman Orthopaedic Institute, our shoulder and elbow specialists see patients for a wide variety of reasons and we offer non-surgical as well as operative approaches to care. Our ultimate goal, of course, is to reduce pain, increase mobility and restore patients to a healthy, active lifestyle.

    Total Shoulder Replacement Surgery

  • What does the recovery time for total shoulder replacement surgery look like?
  • Recovery Time for Total Shoulder Replacement Surgery

    • Youll be given antibiotics to prevent infection.
    • As soon as the day following surgery, youll be able to eat solid food.
    • Your surgeon will determine when you are ready to go home, but it will most likely be a day or two after surgery.

    First Days at Home:

    • Dont underestimate the importance of pain management.
    • Your surgeon and/or a physical therapist will teach you gently exercises to begin right away. You should commit to doing these regularly as they will contribute greatly to your ability to regain strength and range of motion.
    • Expect to have trouble reaching higher shelves and even completing daily tasks such as getting dressed, doing laundry and getting showered. Arrange to have help around the house for at least the first week.

    Weeks Two Through Four, Post Surgery:Up to Six Weeks Post Surgery:Three Months Post Surgery:Six Months to One Year Post Surgery:

    Plan And Prepare Meals

    Its great if you live with someone who can do the cooking, but most of our patients find it helps to plan meals ahead of time. If its feasible, cook extra meals in the weeks before your surgery and freeze them. Otherwise, dont hesitate to purchase frozen, packaged foods.

    Think in terms of foods you can easily pop into the microwave or oven without a lot of preparation. You may not be able to open cans or jars, or clean and cut fresh foods, with one hand.

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    Preparing For Your Surgery

    Before you get your new shoulder, youâll likely get a full physical exam and X-rays or other imaging tests so the surgeon can get a look at the joint.

    Talk to your doctor about any other conditions you have and any medications you take. Youâll have to stop taking certain drugs, especially narcotic painkillers, several weeks before surgery.

    You may have to cut back on drinking and get more exercise, too. If you smoke, youâll be asked to quit. Scientists have found folks who smoke are more likely to have complications from joint replacement surgery than those who don’t.

    Donât eat or drink anything after midnight on the night before your operation.

    The procedure takes about 3 hours. Doctors will give you drugs to put you under during the surgery.

    Youâll want to be sure you have some help with your daily routine lined up for a few weeks after you come home from the hospital. You wonât be able to move your arm very much. If you donât have a relative or friend who can help you out, you might want to check into a rehabilitation center until you can do more things on your own.

    You may also want to move some things around at home to make them easier to get to while you recover.

    What Is The Fastest Way To Recover From Shoulder Surgery

    Sleep After Shoulder Surgery

    Some shoulder surgery recovery tips include adhering to guidelines and advice given to you by your orthopedic surgeon and physical therapist.

    The key components for an optimal recovery include:

    • Proper pain management
    • Keeping activity to defined parameters to avoid increased pain and doing too much, too soon
    • Maintaining adequate nutrition and sleep this allows for optimal healing and minimizing inflammation as your body recovers

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    After The Shoulder Surgery

    Every patient feels differently after surgery, which depends on their general condition, how the surgery went, and other factors. But here’s what you can expect.

    • Many people are unable to move their fingers and wrists for about 24 hours after the surgery. This is a usual symptom, and the function returns, so don’t get shocked – just be prepared.

    • You might have inflammation and bruising on your hand and arm. This is caused by the bruising of the shoulder during the surgery and is normal.

    • Prepare to stay in the hospital for a couple of nights for observation and to address possible complications.

    • You will be able to eat regular food the next day after your surgery.

    What Is The Recovery Like After Total Shoulder Replacement Surgery

    Most patients are given a morphine pump after surgery so they can control their own pain medicine. After a day or so most patients switch over to pain medicine by mouth. The arm will be in a brace but it can be taken off to do therapy. Antibiotics are given by vein for a day to prevent infection. Physical therapy begins the day after surgery and begins with moving the fingers, wrist and elbow. Some motion of the shoulder is begun within a day or so after surgery. The physical therapist will show the patient a program of exercises to do at home. Most patients stay in the hospital from three to five days.

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    What Can You Expect During A Shoulder Replacement Surgery

    Shoulder surgery may take 2 or 3 hours, during which a patient receives regional or general anesthesia. The surgeon uses a metal ball to replace the humeral head and attaches a plastic socket to the glenoid for a total shoulder replacement.

    If a partial shoulder replacement is done, only the ball is placed to replace the joint. And in cases where the rotator cuff muscles are torn a reverse shoulder replacement surgery is necessary. Here the entire process is altered with the ball being used in place of the socket and vice versa.

    It may seem complicated, but with a 90 percent success rate, shoulder replacement surgery is a safe medical procedure. Once the surgery is over, the patient is transferred to the recovery room and kept under observation for several hours.

    Since shoulder replacement is major surgery, you may experience pain in the days or weeks following the procedure. Normally, patients are given pain relief injections immediately after the surgery and oral drugs days after.

    How Can Physical Therapy Help

    How long is shoulder replacement surgery recovery?

    Physical therapy can help a person recover from a total shoulder replacement by guiding the individual through a structured exercise protocol, improving shoulder function and range of motion, and allowing you to get back to pain-free activities.

    Article By: Bridgette Sakar, DPT, PT, OCS

    Bridgette Sakar began her physical therapy career 7 years ago. Bridgette loves working with the athletic population and believes that an active body is a healthy body. Bridgette is a graduate of the HSS Ivy Rehab Orthopedic Residency Program and is a board-certified Orthopedic Clinical Specialist. She currently specializes in orthopedic and sports injuries. Bridgette currently treats patients at Ivy Rehab Physical Therapy in Denville, NJ.

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    What Is The Surgery Like

    The surgery experience is very similar to that of a regular shoulder replacement with a few variations. The main factor in the recovery is whether this is the first shoulder replacement for the shoulder or whether an old prosthesis has to be taken out during surgery. When this is done, it is called a revision case and the recovery may be different than when a first time joint replacement is done.

    The surgery is typically done with a nerve block of the arm followed by a general anesthetic. The incision is in the front of the shoulder and the surgery takes about two to three hours. Postoperative pain relief is obtained with pain medications orally and by vein if needed. Most patients can begin moving the fingers, wrist and elbow the next day.

    Most patients donate a unit of blood prior to surgery which can be given back to them if needed. For first time joint replacements blood is given back to the patient usually only 10 to 20% of the time. For revision cases where the surgery is longer, nearly 80% of cases need a blood transfusion. Similarly, the length of time for surgery is longer for revision cases and the recovery time for gaining function of the arm is longer. Other factors which influence the recovery time include whether bone grafting is done, whether it holds well and how long it takes the bone to heal.

    At The Surgical Center

    Before you go home, a nurse or physical therapist will show you how to wear a shoulder sling to support your arm. You will need to wear the sling for 2 to 4 weeks after surgery. A physical therapist will also teach you simple exercises you should do at home to promote shoulder healing, strength and flexibility.

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    Recovery From Shoulder Replacement Surgery

    Total shoulder replacement surgery has a very high rate of success and satisfaction among patients. Most people who undergo this surgery enjoy significant pain relief and improved function for 10 years or more, because the damaged parts of the shoulder joint are replaced with prosthetic materials in order to restore your normal joint function.

    If you are wondering what the recovery period is like after having shoulder replacement surgery, lets talk about what you can expect.

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