How painful is shoulder replacement surgery?

Shoulder arthroplasty is a complex procedure, which requires a great amount of cutting of deep tissues and bone. The surgeon takes great care to eliminate pain with appropriate analgesia both immediately after surgery and during the rehabilitation process. A long acting local anesthetic infused around the nerves of the joint is often used with general anesthesia during surgery. These regional blocks will provide several hours of pain relief even after a patient has emerged from general anesthesia. A patient-controlled intravenous infusion pump (PCA) is used in the early post-operative period for pain control. By the second or third day after surgery, oral pain relief medication is adequate through the early rehabilitation period (4-6 weeks).

How long before I can return to my normal activities after shoulder arthroplasty?

The time it takes to return to normal activity varies greatly from patient to patient. Most individuals have less pain at night or at rest in the first 2-4 weeks after surgery. Pain with activity persists longer, but generally decreases as the strength and function of the shoulder muscles improve. Full recovery usually takes 4-6 months.

What activities can I safely do after shoulder replacement?

The goal of shoulder arthroplasty is to relieve the pain from glenohumeral arthritis. It is unrealistic to expect to return to repetitive, heavy, overhead activities, which would put the replacement components at risk. Shoulder function after arthroplasty is also unlikely to allow the motions required by these activities.

According to the American Shoulder and Elbow Society, the acceptable activities after a shoulder arthroplasty are:
  • bowling, doubles tennis, cross-country skiing, swimming, canoeing, and shuffleboard
  • for those with previous experience in the activity: golf, ice skating, shooting, and downhill skiing
Unacceptable activities are:
  • football, gymnastics, hockey, rock climbing
  • throwing sports, except for gentle underhand tossing
I've heard that joint replacements sometimes "wear out" and need to be redone. What are the chances I may require a second shoulder arthroplasty?

Long-term studies show that 85-90% of total shoulder replacements are functioning well ten years after implantation, and 75-85% are doing well fifteen years after surgery. Over time, current advances in materials and techniques should improve these percentages even more.

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