North Hampshire Hospital
The Hampshire Clinic
Basingstoke, Hampshire, UK

Mr John Britton FRCS
Consultant Orthopaedic Surgeon

Information for patients undergoing orthopaedic treatment

 


Advice on Shoulder Replacement

Before embarking on shoulder replacement you should be aware of the following facts. If you have any other questions you should ask your surgeon for further information.

Benefits

  • Relief of pain:    Over 90% of patients can expect to lose all, or virtually all, of their shoulder pain.

  • Mobility:  Gain in range of shoulder of shoulder movement following replacement is unpredictable. In some patients movement may return to almost normal, whereas in others there will be significant residual stiffness.

  • Function:    Shoulder function will normally be significantly improved following surgery. Even if you do not regain much movement the reduction in your level of pain will improve your function,

Risks

General risks associated with any surgery

  • Cardiovascular problems:    Heart attack and stroke can occasionally be caused by anaesthesia and surgery. The risks of this complication is normally exceedingly small in healthy individuals. The risk may be greater if you have pre-existing disease, in which case your anaesthetist / surgeon will discuss this with you.

  • Thromboembolism:    Blood clots may sometimes form in the veins of your legs, a condition known as 'deep vein thrombosis.' This may cause excessive swelling of your legs and may require treatment with blood thinning drugs. Extremely rarely the clot may become detached and travel to the lungs; this is a potentially fatal complication known as a 'pulmonary embolus.' There are some conditions in which the risk of thromboembolism is increased (e.g. patients on the contraceptive pill or HRT), in which case you may be given medication to reduce the risk.

Specific risks of shoulder replacement

  • Infection:    Infection can complicate any surgery. It may be possible to treat this with antibiotics alone, but more commonly further surgery and removal of the replacement is necessary. The chance of this occurring is approximately 1%.

  • Nerve and blood vessel injury:  There is a very small risk (<1%) of damage to nerves or blood vessels around the shoulder.

  • Loosening:     It is possible that with time the shoulder replacement will lose its fixation to the bone. This may be associated with deep seated infection, but often occurs without any apparent cause. The chance of this occurring increases with time; there is approximately a 5-10% chance of this occurring within the first 10 years after surgery.

  • Wear:    Physical wear of the prosthesis becomes a problem the longer it has been implanted. Wear debris may induce loosening of the components.

  • Dislocation: Shoulder replacements may on occasions dislocate, although this is a fairly rare occurrence. In this event  a manipulation may have to be performed under a general anaesthetic. In rare instances revision surgery may be required.

Revision surgery

  • If your shoulder becomes loose, worn or recurrently dislocates further surgery may be necessary. It is normally possible to re-insert a new replacement. This type of surgery is normally successful, although is the complication rate is higher than that following primary replacement surgery.

Surgery details

  • Surgery will be done under either general anaesthesia; it is not possible to operate under regional anaesthesia alone. Frequently a regional block will be given in addition to general anaesthesia in which case your arm will be numb for up to 12 hours; occasionally numbness may last for 24-36 hours.

  • The operation will take about 1 to 1 hours

  • Following surgery you will have an intravenous drip for up to 24 hours. Blood transfusion is rarely required.

  • Active movement of your shoulder will be encouraged from the first post operative day. A sling should be worn at night for the first 2 weeks after surgery, but at al other times you should use your arm as much as possible.

  • Most patients are discharged from hospital within 4 to 7 days of surgery

Recovery

  • Your sling can be discarded 2 weeks following surgery.

  • Outpatient physiotherapy is often, but not always, required for a few weeks after surgery.

  • Most tasks of daily living should be possible within 3 to 4 weeks.

  • Driving is normally possible about 6 weeks following surgery.

  • Showers may be taken as soon as the wound is dry (normally within 72 hours).

  • Your progress will be monitored by our physiotherapists and all patients will have a routine follow up check 6 weeks after surgery.

  • It will take 6 to 12 months to fully recover from your  surgery. You will be seen in the outpatient clinic throughout this period.

 

 

For further information please see  www.johnbritton-orthopaedics.co.uk

John Britton FRCS
Consultant Orthopaedic Surgeon

 

J M Britton 2007

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