Shoulder Arthroplasty

• Osteoarthritis
• Rheumatoid arthritis
• Avascular necrosis
• Rotator cuff arthropathy
• Massive irreparable rotator cuff tears
• Trauma – proximal humerus fractures and post-traumatic arthritis
• Previous failed rotator cuff repair or failed ORIF 

You may be a candidate for shoulder arthroplasty if you have the following:

• Severe pain and reduced motion that prevents you from performing your regular activities of daily living or recreational activities
• You have consistent reduced motion and weakness in your shoulder
• You have significant pain that disturbs your sleep
• Conservative treatment, such as rest, physiotherapy or cortisone injections has failed to provide more than temporary relief
• You had prior surgery, such as arthroscopic cuff repair or fracture fixation, that failed to heal properly or address your symptoms

What happens before the procedure?

Before shoulder arthroplasty, you will typically undergo preoperative assessment. You will be asked about your health history in detail. You will be asked to bring along a full list of your medications. You may need to stop taking some of your medications a few days before surgery (especially blood thinners). Before the procedure, you may also need blood tests, a chest x-ray and an ECG (electrocardiogram) or cardiology consult, to make sure it’s safe to proceed with surgery. The anaesthetist will give you specific preoperative instructions, including how long before surgery to stop eating and drinking. Typical recommendations usually suggest no eating or drinking at least six hours prior to surgery.

Admission to hospital - Anaesthesia

Admission to hospital occurs the day of surgery. Shoulder arthroplasty is performed under general anesthesia +/- regional nerve block, which provides pain relief postoperatively for 12-18 hours. Be prepared to stay overnight in the hospital. 

What happens during the procedure?

Shoulder arthroplasty usually lasts approximately 90 minutes, which may vary depending on the complexity of the procedure. It is typically performed under general anaesthetic + regional block (interscalene) but may be done only under regional block, in selected cases. During the procedure, you will be placed in a semi-seated (beach chair) position. The shoulder replacement is performed through a 10 cm incision in the front of your shoulder. After placement of the implants, the wound is closed with buried dissolvable sutures and steristrips. The wound will be covered with a waterproof dressing, but the wound shoulder kept dry for 10-14 days. Your arm with be placed in a sling, to be kept for 3 weeks. 

What to expect after the procedure?

Shoulder arthroplasty usually involves an overnight stay. The regional nerve block provides pain relief for 12-18 hours. Oral analgesics with be provided upon discharge for pain relief at home. The physiotherapist with give you an early home exercise program to avoid stiffness. Your arm with be placed in a sling, to be kept for 3 weeks, after which formal outpatient physiotherapy may start. The wound should be kept dry for 2 weeks, after which it is ok to wash. Return to work varies, based on the occupation, but it may be as soon as 2 weeks after the procedure. You may be unable to drive for a few weeks after the procedure – you must review your insurance policy. Light lifting may start after 6 weeks, but heavy lifting is usually allowed after 12 weeks. You should NOT lift yourself up from a chair or bed with the operated arm for 6 weeks after the surgery. Your first postoperative appointment with the surgeon will be 2-3 weeks after the surgery, for clinical review and repeat x-rays. 

Dr Panagopoulos has extensive experience in both primary and revision shoulder replacement surgery and will discuss all options with you during your visit in the office.

FAQs - Frequently Asked Questions