What to expect after a shoulder replacement surgery
You may need to stay in hospital for two to three days after your operation, depending on how good your general health is.
If you have a local anaesthetic, it may take several hours before the feeling comes back into your treated shoulder. You’ll be given pain relief to help with any discomfort as this happens. Tell your nurse if you’re still in pain.
You may have fine tubes running out from your wound. These drain fluid into a bag and are usually removed after a day or two.
You’ll probably be able to eat normally and get out of bed the day after your surgery.
You may have an X-ray taken of your new joint while you’re in hospital.
Your nurse should give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment.
Having a general anaesthetic can temporarily affect your co-ordination and reasoning skills. So you mustn’t drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards.
Physical Therapy
Arm and shoulder movements are very important for recovery. Usually the first day after surgery, your orthopedic surgeon or another doctor will begin to work with you and teach you specific exercises to regain full arm and shoulder movement.
The doctor will provide you with a list of exercises that you can do to keep your muscles strong without damaging the replaced shoulder. These exercises are necessary to prevent your elbow and shoulder from getting stiff. They will be difficult to perform in the beginning, but will get easier every day. You also will be visited by a physical therapist who will reinforce these exercises while you are in the hospital. During your hospital stay, you will attend physical therapy one to two times a day. An occupational therapist and nurse discharge planner also will help you prepare for your homecoming.
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Recovering from a shoulder replacement surgery
It usually takes at least three to six months to make a full recovery from a shoulder replacement.
For up to four weeks after the operation, you may need to keep your arm in a sling, especially at night. Your surgeon or physiotherapist will give you specific advice about when to wear your sling.
Within a few weeks after surgery, you should be able to do simple everyday tasks like washing and dressing yourself. Don’t place your arm in any extreme positions (such as straight out to your side or behind your back) for six weeks after your operation.
Your surgeon may recommend that you don’t lift anything heavier than a cup of tea for the first six weeks after your operation. Don’t do any heavy lifting or contact sports for at least six months.
Ask your surgeon for advice about returning to work and other activities. You may be able to drive again by about four weeks after the operation, but this will depend on how well you are recovering. You must be able to control your vehicle and perform an emergency stop. If you’re in any doubt about driving, contact your motor insurer so that you’re aware of their recommendations, and always follow your surgeon’s advice.
It’s usual for you to be given some painkillers to take home with you when you leave hospital. Always read the patient information leaflet that comes with the medicine and if you have any questions, ask your pharmacist. Some people need painkillers for longer than others. If you’re in a lot of pain, contact the hospital or your surgeon for advice.
It’s important to continue to do the exercises your physiotherapist recommends. These will help your shoulder to heal and may help you to recover more quickly.
Post-operative Care
You will be discharged from the hospital on the second or third day following your surgery depending on your recovery. Once you have returned home, it is very important to follow your orthopedic surgeon’s instructions during the first few weeks after surgery.
. Medications
You will be given prescriptions for pain medication, anti-inflammatory medicine and aspirin, which helps to prevent blood clots. Use the pain medication only if you are experiencing pain. Take the anti-inflammatory as prescribed.
. Caring for Your Incision
You will have stitches running along your wound on the front of your shoulder. These will be removed one week after your surgery, at your first follow-up appointment. Call your surgeon immediately if your incision swells, drains, becomes red or painful, or if you develop a temperature over 101 degrees Fahrenheit.
Before leaving the hospital, your incision will be covered with a dry bandage. Please do not get the incision wet or dirty. The dressing can be changed daily and it is not uncommon to have a small amount of blood on the dressing. Do not shower or go in the bath until you return for your follow-up appointment. The incision has not healed yet and getting the incision wet puts the shoulder at risk of infection. After the stitches are removed and if the doctor allows you to, you can take a shower and let the water run over the wound. Do not go into a tub or Jacuzzi to soak the wound. Pat the wound dry after you finish showering.
. Physical Activity
Being physically active is an essential part of recovery. Continue to perform the exercises you learned in the hospital. Before leaving the hospital, you will be given a physical therapy exercise plan to follow. Within the next three to six weeks, you need to protect the shoulder so that the muscles can heal. You should have an appointment to see a therapist within the first or second week after you are discharged from the hospital. During the first few weeks of recovery, the physical therapist may teach or help you perform specific exercises to strengthen your arm and shoulder.
You may experience swelling and bruising of the hand and arm. This is normal and results from the swelling and bruising from your shoulder, which travels down the arm. Unfortunately, there is no treatment for this, but it is recommended that you bend and straighten your elbow frequently and make a fist to help keep your circulation flowing.
Your arm will still be in a sling and it is recommended that you wear it when you are in public or moving around. If you are reading, watching television or working at a desk, you may loosen it. When you are getting dressed, it is easiest to put your operated arm through the shirt-sleeve first, then put your sling on. You may use your arm to perform normal daily activities, such as eating, writing or shaving, but you may not lift any items or reach out suddenly until you are instructed that it is ok to do so.
Six weeks after surgery, when you regain full shoulder movement, you can probably return to work, depending on how much physical activity is involved in your occupation. You will also start to strengthen your shoulder up with physical therapy.
. Diet
By the time you leave the hospital, you will probably be eating your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt. Your doctor may recommend that you take iron and vitamin supplements.
Drink plenty of fluids (unless your doctor tells you not to).
You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
. Ice
For pain, put ice or a cold pack on the area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
. Pain
Will I be in pain after my shoulder replacement?
It’s natural to feel some pain after a surgical operation, but don’t worry – immediately after your operation, and while you’re in hospital, you’ll be given pain-relieving medicines. You may be given an injection, tablets to swallow, or have the medicine via a patient-controlled system. This allows you to control the amount of pain relief you receive.
In some cases, even if you have a general anaesthetic, your doctor will also inject a local (regional) anaesthetic into your shoulder. This continues to numb your shoulder even after you wake up.
Before you go home, you can discuss pain relief with your nurse or surgeon. They’ll usually give you some suitable painkillers to take with you. Always read the patient information leaflet that come with your medicine and, if you have any questions, ask your pharmacist for advice.
If your pain is severe or doesn’t improve, contact the hospital or your surgeon for more advice.
Do’s and Don’ts
The success of your surgery will depend largely on how well you follow your orthopaedic surgeon’s instructions at home during the first few weeks after surgery. Here are some common do’s and don’ts for when you return home:
. Don’t use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.
. Do follow the program of home exercises prescribed for you. You may need to do the exercises 2 to 3 times a day for a month or more.
. Don’t overdo it! If your shoulder pain was severe before the surgery, the experience of pain-free motion may lull you into thinking that you can do more than is prescribed. Early overuse of the shoulder may result in severe limitations in motion.
. Don’t lift anything heavier than a glass of water for the first 2 to 4 weeks after surgery.
. Do ask for assistance. Your physician may be able to recommend an agency or facility if you do not have home support.
. Don’t participate in contact sports or do any repetitive heavy lifting after your shoulder replacement.
. Do avoid placing your arm in any extreme position, such as straight out to the side or behind your body for the first 6 weeks after surgery.
Many thousands of patients have experienced an improved quality of life after shoulder joint replacement surgery. They experience less pain, improved motion and strength, and better function.
Possible Surgical Complications
Shoulder replacement Success Rate
Shoulder replacement is a very successful operation and the 15 year survival rate is up to 90 percent. Many patients end up with extremely functional shoulders and are able to return to the activities of daily living and low impact sports without pain. The operation may have some complications, although they are very rare. Complications may include infection, bleeding, shoulder instability, tearing of the rotator cuff, fracture and loosening of the prosthesis.
How long will shoulder replacement last?
It’s difficult to say just how long your shoulder replacement will last. Experts estimate that most modern shoulder replacements will last for at least 15 to 20 years.
Revision surgery for a shoulder replacement is rarely needed.