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Shoulder Arthroplasty

WHAT YOU NEED TO KNOW:

Shoulder arthroplasty is surgery to replace the shoulder joint. The shoulder joint includes the humerus (upper arm) and the scapula (shoulder blade). Healthcare providers use a prosthetic (artificial) implant for the replacement.

WHILE YOU ARE HERE:

Before surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.
  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  • Monitoring:
    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    • A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine.
  • Anesthesia:
    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
    • Intravenous (IV) regional anesthesia: This is medicine put into an IV in the injured arm or leg. A pressure cuff is first put on your arm or leg. After the cuff is tightened, the medicine is put into the IV. The cuff keeps the medicine in the arm or leg so you will not have pain.

During surgery:

  • An incision will be made in the front of your shoulder and all parts inside the joint checked. Your arm will be moved in certain directions to pop out the head of the humerus. Any loose bones or bone spurs on the humerus will be removed.
  • Healthcare providers will remove the head of the humerus. The shaft (inside of your humerus) will be drilled and cleaned out so the prosthetic stem can be put inside. If the end of the shoulder blade will also be replaced, the shoulder socket will be shaved to make it smoother. Defects in the bone may be filled with cement or bone taken from the removed head. Holes are then made in your scapula for the artificial socket to be attached. Surgical cement may be used to hold the socket and stem firmly in place.
  • The tendon is reattached to the humerus, torn muscles repaired if needed, and the ball put into the socket. Thin rubber tubes may be put into your skin to drain blood from your incision. The incision will be closed with stitches, except for where the tube is placed, and covered with bandages. Healthcare providers will check your shoulder by moving your arms in different directions to check for limitation of movements. This will be needed to plan for your rehabilitation after surgery. Your arm will then be put in a sling or splint to keep your shoulder joint from moving.

After surgery:

You will be taken to a room where your heart and breathing rates will be monitored. Do not get out of bed until your healthcare provider says it is okay. A bandage may cover the incision wounds to help prevent infection. When healthcare providers see that you are okay, you may be able to go home. Someone will need to drive you home and stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

  • Activity:
    • Your arm may be placed on a continuous motion machine right after surgery. This machine moves your arm back and forth very slowly. This may be used for the first 24 hours after surgery.
    • Do leg exercises until you can get out of bed. Do this by drawing circles with your toes. This may help decrease the risk of blood clots in your legs.
    • Ask your healthcare provider when you can get up for the first time. If you feel weak or dizzy, lie down right away and call your healthcare provider.
  • Take deep breaths and cough 10 times each hour. This will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath, then let the air out and cough. Repeat these steps 10 times every hour.
  • Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.
  • Medicines:
    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.
    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
  • Physical therapy: A physical therapist will teach you exercises to help improve movement and strength, and to decrease pain. Physical therapy may not be started right away if other procedures were done, such as a rotator cuff (muscle) repair.

RISKS:

Surgery may cause you to bleed more than expected or to develop an infection. Other parts of the shoulder, such as nerves, blood vessels, ligaments, muscles, and bones may be damaged. Your shoulder may become stiff, numb, and more painful. The implant may be placed incorrectly. It may loosen or break, and bone spurs may form. Even after successful surgery, your shoulder movement may not be the same as it was before. You may have trouble going back to your usual activities, including sports. If left untreated, the pain and problems you have with your shoulder may get worse.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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