SHOULDER

Shoulder Replacement

In a healthy shoulder, the joint is lined with cartilage which acts like a cushion and smooth surface allowing easy, frictionless movement. Degeneration of cartilage in the shoulder means there is no layer to act as a shock absorber or reduce friction causing pain and difficulty moving. The decision to proceed with a shoulder replacement should be considered when non operative treatment has been ineffective, and discussed with your surgeon and family members. The goal of surgery is to relieve pain and improve mobility by replacing the damaged bone surfaces with artificial humeral and glenoid components.

Procedure

Typically a conventional total shoulder replacement is indicated for patients with bone-on-bone osteoarthritis and intact rotator cuff tendons. First an incision is made over the shoulder to expose the joint and the muscles overlying the shoulder are cut to expose the head of the humerus. The humeral head is dislocated and released from the capsule and the damaged part removed. 


Dr du Sart then moved to the glenoid (socket). The arthritic part of the socket is removed and prepared to take the glenoid component. It is sized for the appropriate implant and pressed into the socket. 


A bone tunnel is made in the humerus to take the humeral stem. The humeral component is then inserted into the upper arm bone. This may be press fit relying on bone to grow into it or cemented depending on a number of factors such as bone quality and surgeon’s preference. 


The humeral head component is then placed on the humeral stem and the prostheses are fixed in place. The joint capsule is stitched together and the muscles and tendons are repaired.

After Your Operation

Pain Management

During your inpatient stay you will be given pain relief and either medication or prescriptions to go home to keep pain within comfort. Usually patients will initially require regular pain relief consisting of paracetamol and anti-inflammatories if indicated. Stronger medications may be given and helpful in early stages however are phased out as comfort levels increase. Regular ice packs on the shoulder for approximately 20 minutes, three to four times a day can help reduce swelling and pain. 


Return to Work and Sport

Return to work will vary depending on the nature of your work. After surgery, your arm will be placed in a sling for two to four weeks. In general, you should plan to have at least two weeks off work to allow adequate time for your shoulder to heal while your arm is in a sling. You may be able to return to light duties after approximately two weeks, but if your work is physically active and involves lifting, pushing or pulling, it may take up to twelve weeks to return. Returning to sport is dependent on the activity and extent of surgery.  Dr du Sart will discuss your return to activity at your post-op check.


It is important to follow the physical therapy exercises you are provided to increase shoulder mobility and strength.


Driving

Times to return to driving will vary. However, in general, plan to avoid driving for approximately six weeks and until your sling is removed. If you have concerns, you can discuss this with Dr du Sart.

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