Shoulder replacement surgery, also known as shoulder arthroplasty, can help reduce pain and improve movement.
Surgery may be recommended if other options such as steroid injections and pain killers aren’t working for you. Arthritis is the most common reason for having shoulder replacement surgery, but you may also have it because of a fracture or repeated dislocation.
How do I get shoulder replacement surgery?
There are several ways to be referred for shoulder replacement surgery. You can visit your GP who can refer you to an NHS orthopaedic surgeon. Orthopaedic surgeons specialise on your musculoskeletal system which includes your bones, muscles, tendons and ligaments. They can then assess if you need surgery.
Your GP may also refer you to the private sector. Or you might also be able to self-refer to a private clinic. If you have private health insurance, you can speak to your insurer. If they cover the procedure, they can help you find a suitable consultant at a hospital near you.
You can find out more details about accessing private healthcare on our website.
How do I prepare for shoulder replacement surgery?
Your doctor will go through what you need to do to prepare at your pre-assessment appointment. You’re likely to need some imaging such as an ultrasound, MRI or x-ray to help plan your surgery.
Looking after your general health through exercise, diet and stopping smoking can also help your recovery.
Before your surgery, you’ll need to arrange transport to and from the hospital. You won’t be able to drive immediately after your procedure and it’s not advisable to use public transport to get home. So, you may want to arrange a lift or taxi. Your hospital may be able to help with this and can tell you if you qualify for free transport.
Stocking up on meals you can easily prepare is also helpful. You may also want to arrange social support for everyday tasks you may find difficult while you recover.
You may be asked to avoid eating and drinking from midnight on the day when you’re booked in to have surgery.
What happens during shoulder replacement surgery?
On the day of your surgery, your surgeon and anaesthetist will assess you beforehand. They’ll explain the procedure’s risks and potential benefits. Then they’ll give you a consent form to sign if you still want to go ahead.
Before the operation, you may be given general anaesthetic to put you to sleep. Or, you may be given local anaesthetic which is sometimes called an interscalene nerve block. There will be other forms of pain relief which your anaesthetist will go through with you on the day.
You may also be given antibiotics to reduce the risk of you getting any infections.
The operation is then likely to be done using keyhole surgery which involves several incisions of 5 to 8 mm being made. The surgeon will monitor what they’re doing on a screen.
You’ll then be given a prosthetic shoulder replacement typically made of metal and plastic. Afterwards they will close your incision using clips, glue, stitches or medical tape.
After the operation your shoulder and upper arm will be numb. You’ll be given a sling to wear and your wound will have a water-resistant bandage.
What are the various types of shoulder replacement surgeries?
Your shoulder is a ball and socket joint which allows you to move it. It also has a rotator cuff and ligaments to move and stabilise it.
To repair damage to your shoulder, you may be offered one of the following types of shoulder replacement surgeries:
- Total shoulder replacement is one of the most common types. It replaces the ball of your shoulder with metal and the socket with plastic. This can only be done if your rotator cuff is working properly.
- Reverse shoulder replacement is another common type but it’s done if your rotator cuff is not working. In this case the ball and socket are switched around so different muscles are used to move the arm.
- Partial shoulder replacement only replaces the ball and is done when the socket is working properly.
- Shoulder resurfacing is done by fitting a metal cap to the ball of the joint, so less bone is removed.
- Revision surgery may be necessary if there are complications after your initial surgery such as the rotator cuff not working or the implant loosening. According to some research, revision surgery is less likely to be necessary when it’s carried out by surgeons who typically carry out more than 10 replacements per year.
Shoulder replacements can last 10 to 20 years. You might want to ask your surgeon about the pros and cons of each of these types of surgery.
How long does it take to recover from shoulder replacement surgery and what should you expect afterwards?
After your operation, you’ll be monitored in a recovery room while your anaesthetic wears off. It’s normal to have some bruising afterwards and you can expect to feel tender and sore. Your arm may have a numb or heavy feeling for the next day or so.
You’ll be on pain relief medications while you recover and you’ll only be discharged if your pain is under control. A cold compress wrap may also be used to reduce swelling and inflammation.
You’ll also be shown how to keep your wound as dry as possible while you have the water-resistant dressing on. For example, you’ll need to have showers instead of baths.
Moving and walking are often encouraged after surgery to help with recovery and reduce the risk of complications. You may also need a catheter, oxygen mask and drainage tubes from your wound to support your recovery.
Soon after your operation, you’ll be given a series of exercises to do by a physiotherapist. They will tell you when you can start the exercise and which movements to avoid.
When you can exercise and what you can do is individual and your physiotherapist will guide you. Typical exercises include shoulder shrugs and forearm rotations. You may need assistance with some of the exercises.
You may also need some equipment to help with everyday tasks when you get home. An occupational therapist may help you choose and use the equipment you need.
What are the potential complications of shoulder replacement surgery?
Shoulder replacement surgery has some potential complications which will be explained by your surgeon beforehand.
Some of these complications include:
- The risk of getting an infection. Your surgical team will take precautions to minimise the risk.
- Nerve or blood vessel damage which occurs in fewer than 1 in 100 people. There are ways to repair the damage if this happens.
- Dislocation, stiffness or a fracture in the shoulder.
- Deep Vein Thrombosis (DVT) which is where you develop a blood clot. This is estimated to occur in 3 in every 100 patients having orthopaedic surgery. This figure may be much lower for shoulder replacement surgery.
- Loosening of your prosthesis.
- Side effects from your anaesthetic such nausea and heart problems.
- Scarring but these usually become invisible over time.
Before your surgery, you’ll go through a full list of potential complications. You can ask about the likelihood of each happening if they don’t give you this information. You can also check the National Joint Registry’s Adverse Outcome Predictor for Shoulder Replacement.
When am I likely to be discharged?
Everyone’s recovery time is different but you are likely to need to spend a day or two in hospital.
How long you spend in hospital depends on several things such as how your wound is healing and if you have social support available when you leave.
Once you’re home, a district nurse will visit you at home to check your wound. You may be asked to arrange for your GP practice nurse to remove your dressings and any stitches 10 to 14 days after your surgery.
If you experience any redness, report this to your GP as this might be a sign of an infection.
You’ll have a follow up clinic appointment after six weeks.
What costs and fees are involved in private shoulder replacement surgery?
The initial private consultation costs and the procedure’s costs will be detailed on your hospital’s website. If they’re not, you can call to ask about them. Typically, a shoulder replacement costs between £7,000 and £15,000.
If you’re self-funding, you can find out more in our guide on paying for private healthcare.
What patients who have had shoulder replacement surgery say
Although everyone’s experience is likely to be different, it can be helpful to speak to others who have had shoulder surgery.
Some patients who have shared their experience of shoulder replacement surgery say:
“I’ve reduced the number of painkillers I’m taking, I’m sleeping better – with longer stretches at night than I’ve had in years. The difference is remarkable.”
“Since the surgery, my shoulder mobility has got better and better. I am now able to do all the things I was unable to do for some years prior to surgery such as playing golf… but most importantly I am pain free.”
“It is like I have been given a new lease of life.”
How might shoulder surgery impact me?
After your surgery you’ll have to do most things, one handed while you’re wearing a sling. You’ll typically need to wear it day and night for four to six weeks after surgery.
It’s therefore a good idea to make some adjustments like using pre-chopped vegetables and easy grip jar openers.
Afterwards it’s better to have showers rather than a bath to minimise the risk of the wound getting wet. You may have a collar and cuff for showering if you need it.
Loose clothing with front fastening is easier to wear and if you wear a bra, front fastening ones might be more comfortable. You’ll also need to avoid lying on the operated arm while you sleep.
Although everyone’s different, your timeline for recovery may look as follows:
- You’re likely to need to take six weeks off work.
- For up to six weeks, you’re likely to have to avoid actively using the arm that’s been operated on. You’ll also need to avoid anything weight bearing like holding a stick or pushing up from a chair.
- After six to 16 weeks, you may be able to gradually start returning to normal activities. You may be able to do some light swimming like breaststroke.
- After 12 weeks, you may be able to do activities like light jogging or gym exercises and golf.
- After 16 weeks or more, you may be able to return to normal activities if they're comfortable to do. You’ll need to be careful when doing heavy tasks or lifting your arm above shoulder height.
- It may take weeks or months before you can safely drive again. It’ s important to discuss with your surgeon when it may be safe to drive again. You don’t need to notify the DVLA about your operation. However, it’s a good idea to check you’re covered by your insurance.
Shoulder replacement surgery near you
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