Shoulder Joint Replacement

Shoulder joint replacement surgery is a surgical procedure used by orthopaedic surgeons in cases of joint damage as a whole or part of the joint, this necessitates replacing the damaged joint by a surgical intervention that involves anaesthesia of the patient and the installation of an artificial joint instead of the damaged one that creates a good level of movement to the joint.

The shoulder joint is basically a three-bone junction: humerus, scapula, and clavicle (collarbone), the shoulder joint is classified as a "ball and socket," so that the head of the humerus forms the ball, while the remaining bones form the socket that facilitates movement of the shoulder joint in many directions.

Shoulder joint replacement is often preceded by intense and unbearable pain caused by wearing off the joint cartilage, resulting in pain due to bones friction, in addition to other annoying symptoms.

Orthopedic surgeons may have to replace the shoulder joint of some patients in the following cases:

• Osteoarthritis in the shoulder joint.
• Rheumatoid arthritis.
• Fracture or injury in the shoulder joint.
• Tearing tendons of rotator cuff muscles.
• Avascular necrosis.
• Continuous feeling of severe pain in the shoulder joint.
• Limited range of motion in the shoulder joint.

The patient is required to undergo a series of tests before a shoulder joint replacement to verify his physical and health ability to undergo such surgery, including:

• Patient's medical history.
• Physical examination of the joint.
• X-rays for the shoulder joint.
• Magnetic resonance imaging (MRI) or computed tomography (CT) to detect soft tissues in the shoulder joint.
• Electrocardiogram (ECG).
• Laboratory tests such as blood tests.

Patient's preparation before the surgery:

The patient is advised to avoid certain medications prescribed by the surgeon, such as arthritis and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and sodium naproxen; to reduce the chance of any abnormal bleeding. Also, the patient should avoid smoking for approximately two weeks before the date of the surgery. 

The patient begins to fast from food and drinks from midnight before the surgery.

Shoulder replacement surgery includes the following steps:

1. Anesthesia of the patient (general anesthetic).
2. Making an incision in the shoulder area.
3. Removing the damaged joint and replacing it with a metal joint. Sometimes the part of the ulna's head in the joint is changed without total replacement depending on the patient's condition.
4. Closing the incision with stitches and covering it with a bandage.

A shoulder joint replacement surgery can be associated with a range of risks and complications, just like any surgical procedure in the operating room, such as:

• Infection.
• Bleeding.
• Relocation of the new shoulder joint.
• Rupture the rotator cuff muscles.
• Defect in the artificial parts of the joint.
• Injury of nerves in the shoulder joint.

The patient often needs to stay in the hospital for 2 days after the surgery.

The recovery period and return to normal activities after a shoulder joint replacement may take approximately 2 to 6 weeks, where the area of the joint remains covered with a splint to limit the movement for approximately four weeks, during which the patient must take into account a number of tips and instructions to get the best results to ensure him using the new shoulder joint efficiently, 

Patients advised to follow some tips after shoulder joint replacement include:

• Avoid lifting any heavy weights for at least 4 weeks.
• Avoid pushing or dragging anything.
• Start physical therapy with the assistance of a physiotherapist to learn some shoulder exercises to rehabilitate the joint.
• Keep the wound dry and clean around the shoulder joint.
• Do not move the arm in certain directions such as stretching it straight or bending it behind the back.

• Hip replacement surgery
• Elbow arthroscopy
• Wrist arthroscopy

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Last updated on 23 December on 2021

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