Shoulder arthroplasty is a treatment to restore joint function and relieve pain. It’s usually performed after your doctor has tried other treatments and these have not improved your shoulder functionality.
Understanding Surgery Methods
There are two types of arthroplastic surgery: joint resection and interpositional reconstruction. The former involves removing a part of the bone from the stiffened joint to increase space between the bone and socket, thus improving your range of motion. Scar tissue eventually fills the gap and narrows the joint space once again. You’ll experience pain relief and greater ease of motion, but after this treatment your shoulder joint is not as stable as it was. This is something your doctor should explain and make clear to you before such a surgery.
Interpositional reconstruction reshapes the joint and includes the insertion of a prosthetic disk, which can be plastic, metal, ceramic, or even made of body tissue. If this surgery fails, the next step is to look at a total shoulder replacement. In this type of surgery, the surgeon replaces the round end of the arm bone with an artificial stem that has a rounded metal head, and the socket part of the shoulder blade with a smooth plastic shell or lining that is held in place with a special cement.
Potential risks are an allergic reaction to the artificial joint, blood vessel or nerve damage during surgery, bone breakage during surgery, dislocation of the artificial joint, and loosening of the implant over time. There is also the usual risk with any surgery, in the form of allergic reaction to anesthesia, post-operative infection, and blood clots.
Keep in mind that a joint that has undergone surgery is less stable than a healthy joint and dislocation or loosening of the resected joint may occur, especially with inappropriate physical activity.
These surgeries are not always successful, especially if you also suffer from rheumatoid arthritis. Repeat surgery may be necessary.
Preparing for Surgery
As a patient, it is your responsibility to prepare for surgery. Your doctor will advise you to avoid exercising the shoulder beforehand, because doing so will only aggravate your shoulder and cause more pain.
Part of preparing for your surgery is to take responsibility for how you will function when you get home. You will need to create workarounds for yourself to accomplish your usual daily tasks one-handed. Plan to bring in some help for certain tasks, for example walking your dog, bringing in groceries, and any other activity that will be difficult for you if you have only one hand and you’re experiencing significant pain.
If you drive, make sure someone is available to get you wherever you need to go for the first two weeks after your surgery. Remember you should never, ever get behind the wheel while taking pain medications. Even if you go without your pain meds, you can strain your arm while driving.
After surgery, you may stay in the hospital for one or two days, and very rarely perhaps three. You’ll receive pain medications and antibiotics, and it’s very important to follow all instructions on your prescriptions. Infection is a significant concern after this type of surgery.
Recovering from Surgery
Patients usually report much smoother shoulder movement after surgery, but for a few weeks you can expect more pain than you had before your surgery. Don’t panic! After about two weeks the pain should begin to subside.
Physical therapy (PT) begins immediately after surgery to improve your strength and range of motion. Your physical therapist will teach you how to move your arm around by using your other (good) arm to help. PT is the most important aid to recovery and may continue for months. Lifestyle changes may include readjusting the way you sleep, sit, and work to avoid causing more stress to your shoulder.
As far as returning to work, your doctor is likely to recommend a two-week wait if you work at a desk, and as much as three months for laborers like construction workers.
You can expect to wear a sling for two to six weeks with no active movement. Arm strengthening exercises begin after about three months. It’s very important not to overstress or destabilize your shoulder during the recovery period. If you’re at work during this time, keep a copy of your doctor’s instructions with you in case management urges you to do more than you should. If necessary, provide your instructions to HR so they can protect you during this important healing process.
Total recovery time ranges between four to six months. You will need to follow all instructions regarding activities that you should avoid. You’ll also receive exercises to do at home. You must follow these instructions exactly, since doing the exercises incorrectly can injure your new shoulder.
Refusing to follow the instructions provided, for example by lifting more than recommended, going bowling, or pitching a baseball game before a doctor releases you to do so can void your warranty on the artificial joint.
Your Future Prognosis
What lies ahead for you? Shoulder replacement surgery relieves pain and stiffness for most people. You should be able to resume your normal daily activities after the recovery period. Many people are able to participate in sports such as golf, swimming, and bowling. These activities should only take place after your doctor has released you to do so.
Do you have concerns regarding whether your boss will treat you fairly, or how Workman’s Compensation will help with your shoulder surgery? Contact us today. We’re happy to talk with you about it.