Shoulder Replacement

Learn more about shoulder replacements at King Edward VII’s Hospital

We know if you suffer from shoulder pain, it can be hard to go about your daily life unhindered. Here you can find out more about our London shoulder replacement specialists and find out if this procedure is the right option for you. On this page King Edward VII’s Hospital London shoulder replacement consultants answer your questions about the procedure.

Your surgeon will evaluate your situation carefully before making any decisions. They will discuss with you which type of replacement would best meet your health needs.

Why would I need shoulder replacement surgery?

People who require shoulder replacement surgery most often suffer from osteoarthritis, but an injury to the shoulder also might necessitate the need for this procedure.

What symptoms does shoulder replacement surgery address?

Most people who have this procedure no longer have shoulder pain and are able to move their arm and shoulder more easily, with an increased ability to perform functional activities.

When should you speak to your specialist about shoulder replacement surgery?

If you are experiencing extreme shoulder pain that makes it difficult to move or perform everyday activities and alternative treatments have not helped, it might be time to consider speaking to your shoulder replacement specialist about the possibility of undergoing shoulder replacement surgery.

How is shoulder replacement surgery performed?

Shoulder replacement surgery takes approximately 60-90 minutes and you will be under general anaesthetic. The anaesthetic is often supplemented with a nerve block (inter scale block). This involves an injection of local anaesthetic to numb the nerves that supply the feeling and muscles around the shoulder. It greatly reduces the feeling of pain, and also makes the arm heavy until the block wears off. It reduces the requirement for pain killers after your operation.

The shoulder replacement consultant surgeon will make an incision to the front of your shoulder and remove the damaged shoulder joint and replace it with a prosthetic one.

What is the recovery for shoulder replacement surgery?

Your recovery from shoulder replacement surgery can depend on multiple factors, including your age, fitness level and the nature of your procedure.

After the procedure, your arm will be in a sling and you will not be able to fully use it. You will need to wear the sling for 48 hours constantly, removing it to regularly exercise your arm and shoulder. Wear at night for up to 6 weeks and in public as required and start weaning down the use after 6 weeks. You can remove it in controlled environments such as sitting at home or work.

In the 2-6 weeks after your surgery, you will be required to do exercises and will be given guidance on increasing your range of movement and on restoring strength to your arm.

You should avoid any painful movements and exercise within the limits of pain. Don’t repeat any movements that involve reaching over shoulder height.

From 6 weeks onwards, you should be working on restoring:

• Full movement to the shoulder
• Full strength in the arm
• Your ability to perform the majority of functional activities

Recovery may take up to 6–9 months for full benefit. However, you should start to notice the vast majority of recovery within 12 to 24 weeks.

You and your surgeon will decide upon your best recovery options after your surgery.

Are there any risks/complications associated with shoulder replacement surgery?

As with any medical procedure, it is possible for risks or complications to arise. It is best that you speak with your GP or surgeon about how best to avoid any adverse reactions.

Most people who undergo shoulder replacement surgery don’t experience complications, but they are possible. Some of the most common risks and complications that have been associated with the procedure are:

• Nerve damage
• Infection
• Pain
• Scarring
• Bleeding
• Blood clots
• Loosening of the prosthetic
• A tear in the rotator cuff
• Dislocated shoulder
• Shoulder stiffness
• Shoulder fracture
• Failure or degradation of the prosthetic

How can I prepare for shoulder replacement surgery?

Prior to shoulder replacement surgery you should meet with your surgeon to discuss the specific preparations you should make before your operation. During this meeting you may be asked general questions about your health and medical history.

It’s very important to ask any questions that you might have about shoulder replacement surgery with
your surgeon prior to the operation.

It is wise to ensure you are as healthy as possible at the time of your surgery:

• Remain as active as you can before your admission
• Eat healthy foods including plenty of fibre to avoid becoming constipated after your surgery
• Consider stopping smoking

If you live alone, you might want to consider post-op rehab or convalescent, social services engagement or private carers. Re-arrange furniture and remove any obstacles that are potential trip hazards.

Ensure that you have an appropriate chair to sit on (one with arms and a raised back), as you will need to avoid sitting on a sofa.

Ensure that your bed is at a good height for you to be able to get on and off easily.

Are there alternatives for shoulder replacement surgery?

There are other treatments that you might consider before undergoing shoulder replacement surgery,
including:

• Using over-the-counter painkillers such as paracetamol or ibuprofen
• Exercise
• Physiotherapy
• Steroid injections into the shoulder joint