Where can I find information on my upcoming shoulder surgery?
You’ll find answers to common questions that patients ask before their shoulder surgery on this page, and on the following links:
- Patient Expectations – what to expect from your surgery
- Discharge Instructions – going home from the hospital
- Tips for Self Care – a list of tips that may help during your first week home
- Rehabilitation – what you will be doing in the first several months after your surgery
- The Interactive Shoulder – see how several surgeries are performed, and learn about shoulder anatomy with this demonstration model
What type of prosthesis do you plan to use (e.g. type of metal, etc.)?
There are several companies that manufacture shoulder implants. The type of implant that your doctor may recommend can dependent upon several factors. Because every patient has unique needs, this subject is best discussed with your doctor. For information on specific implants, please check the manufacturer’s web site:
How will the prosthesis be attached to the remaining bone? Is it cemented?
There are both cemented and noncemented shoulder prostheses.
A noncemented prosthesis is tapped into the humerus bone place during the surgery, and it is initially held steady by forces called hoop stresses–like a cork being pressed into the top of a bottle. Noncemented prostheses have a roughened surface, and eventually the surrounding bone will grow into the rough metal surface to provide additional stability.
Sometimes the humeral component is cemented into place. This technique is more common for revision surgery.
The polyethylene glenoid component (the socket) is almost always cemented into place at the time of surgery.
When do patients usually start moving their arm after surgery?
This will depend upon the type of surgery as well as the condition of the bone and soft tissues at the end of your surgery. For a first-time shoulder arthroplasty, patients will often be asked to begin moving the arm with the assistance of a physical therapist the day after the surgery. Discuss your particular case with your surgeon.
How long will I be in the hospital after a shoulder surgery?
Your doctor will take several things into account in deciding how long you need to stay in the hospital. There are a few goals that most doctors like to see their patients meet before going home. You should be able to:
- walk independently
- get in and out of bed by yourself
- not require IV pain medications
- eat and drink without becoming nauseated
In general, once these goals have been achieved, the patient may be discharged to home.
What types of anesthetics are used for these surgeries? Is one kind better than others? How is the decision made as to which to use?
A general anesthesic is given to the patient before the surgery starts. This means that the patient will be asleep during the procedure.
An interscalene block may be administered before the surgery as well. An local anesthetic (e.g. bupivcaine) is injected near the nerves as they exit from the neck region. This often leads to better pain control with less need for narcotic pain medications postoperatively.
What arrangements do you make for pain medication?
Your physician will often give you a prescription for pain medications to help ease the postoperative pain while you’re recovering at home.
When can I return to work?
The answer depends upon the type of work that you perform. If you have a sedentary job you may return to work as soon as you are comfortable enough to do so. If the job requires strenuous physical activity you may need to wait several months. You should discuss your situation with your physician.
Is there a threat of dislocation of my shoulder after the surgery? Will there be any specific precautions I will need to take?
While dislocation is possible, it is rare for this to occur after shoulder arthroplasty. The authors of one paper* reported an incidence of 2.8% (5 out of 176 shoulders) for this complication. However, 4 out of 5 of the dislocating shoulders in this series of patients were associated with either a loose glenoid component or a torn rotator cuff. Thus, there was only one shoulder out of 176 that dislocated without another known associated problem.
If you follow the standard shoulder precautions the risk of dislocation or other injury will be minimized.
*Norris TR, Iannotti JP. Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. J Shoulder Elbow Surg. Mar-Apr 2002;11(2):130-135.
I understand there are machines that passively move arms through full range of motion. Is this something that would be useful to me?
In general, most patients do not require a passive motion machine, though there may be special cases where your doctor prescribes one.
Can I do damage to the shoulder by doing any particular movements or doing too much?
Yes! A patient can ruin the results of a would-be successful surgery by not following the surgeon’s postoperative instructions. Overdoing it and underdoing it can both lead to poor results. See the physical therapy page for more information.
Can I use my hand and arm to cook, cut food, feed myself, use a computer keyboard, etc.?
You will need to follow your doctor’s postoperative instructions. Most often the patient is asked to let the arm hang loosely at the patient’s side for the first eight to twelve weeks after surgery.
When can I drive a car?
Therefore, driving is inadvisable until your doctor allows you to advance to the active motion phase of physical therapy. You should not drive while under the influence of narcotic pain medications.
How much assistance will I need after the surgery?
Individuals vary in their ability to adapt to accomplishing activities of daily living with one arm. It is recommended that you make arrangements to receive help from family or friends when when you first go home from the hospital.
When can I take a shower?
You may shower as soon as you are comfortable enough to do so. It is important to keep your wound dry during the first two weeks after surgery, so you will need to cover the wound before you take shower. Tegaderm is a plastic dressing that seals off the the wound area and prevents water from reaching it. Also, because TegadermT is clear it allows you to see whether or not the dressing needs to be changed.
You may shower and let water run over the wound immediately only if your surgeon used an adhesive glue to close the wound.
How long will it take to reach full recovery?
Much of your strength and range of motion will return within the first three months, but your shoulder will continue to improve over the first postoperative year.