What is a Total Shoulder Replacement?

A total shoulder replacement is a similar procedure to either a total hip or knee procedure and involves replacing the head of the humerus bone (upper arm bone) and the glenoid (part of your shoulder blade) with artificial components. Typically, the components are made up of metal and plastic materials and may vary from a surgeon’s preference and what is most appropriate for the patient.

Shoulder Replacement illustration

Who Would Benefit from a Total Shoulder Replacement?

There are specific medical conditions and circumstances which would warrant a patient to have a total shoulder replacement. Majority of the time a patient will elect to have a total shoulder replacement due to severe osteoarthritis. Other conditions may include rheumatoid arthritis, significant rotator cuff tear, avascular necrosis, and possibly fractures. Some factors to consider if you would be appropriate for a total shoulder replacement would be the severity of the pain you are experiencing and how it is affecting your everyday life. Patient’s would benefit from a total shoulder replacement if you are experiencing significant decreases in your range of motion and strength which limits your ability to lift, carry and reach for objects, impairs your ability to consistently have a good night’s sleep, and having unsuccessful outcomes with conservative treatments such as physical therapy or cortisone shots.

What Does the Surgery Entail?

For the day of surgery, a patient will go to a hospital for the procedure and depending on the surgeon’s preference, will determine if the patient will need to stay overnight or for however many days. A patient should expect the use of some form of anesthetic and will be determined prior to the surgery. The surgery itself generally takes around 2 hours. After the surgery, a patient will be in the recovery room for 1-2 hours while having their vitals monitored to ensure they are within a safe range and prior to being transferred to their hospital room. Depending on how long a patient stays in the hospital, he/she will receive physical and occupational therapy to begin the patient’s rehabilitation process with exercises and training on how to perform activities for daily living such as dressing, feeding, etc.

What are the Precautions after having a Total Shoulder Arthroplasty?

A patient who elects to have this surgery should expect to have precautions with specific movements and lifting precautions. The patient will be in an arm sling for up to 2-4 weeks depending on the surgeon’s preference to help support the shoulder and decrease the risk of dislocation/subluxation. The patient will not be able to actively use their arm by lifting/reaching their arm, supporting their body through their hand, and are unable to lift and carry objects for 4-6 weeks depending on the surgeon’s protocol. These precautions will slowly be lifted over time as the patient continues to heal.

What to Expect for Physical Therapy?

After having your surgery, you will have physical therapy to help improve your range of motion and strength to allow you to reach, lift and carry objects with less difficulty and restriction. The physical therapy process is long. It can take up to 12+ weeks to fully recover and regain your full range of motion and strength. The reason why the recovery process takes so long is due to the precautions you will have after the surgery and you will need time to heal to decrease the risk of dislocation/subluxation of your shoulder. The physical therapist you will be working with will slowly progress your exercises and stretches appropriately and at the correct time. The physical therapist will also utilize manual therapy to help improve your range of motion quicker and also manage your pain appropriately. Although the recovery process is long, it is well worth it as you will notice an improvement within your range of motion, strength, and quality of life compared to how you were prior to having the surgery.

Eric Whelan graduated from Concordia University (Portland, OR) with a Bachelor of Arts in Exercise Sports Science. He then went on to pursue his Doctor of Physical Therapy from Concordia University (Wisconsin).