I am frequently asked when it is time for someone to consider having shoulder replacement surgery. How do you know when you should go ahead and make that commitment to replace my shoulder and improve your quality of life?
It really comes down to a couple of factors in my mind:
1). Are You Able to Sleep at Night?
The number one factor when considering shoulder replacement surgery relates to sleep.
If you have pain at night or difficulty finding a position of comfort when sleeping, that can significantly and negatively impact your quality of life.
If you’re not getting enough rest and rejuvenation during healthy sleep, you won’t be as productive in your everyday life.
I recommend thinking long and hard about if your sleep is being interrupted by shoulder pain that’s due to arthritis. If so, it’s probably time to consider shoulder replacement.
2). Are You Able to Do the Things You Need to Do or the Things You Enjoy?
We all have activities that we enjoy doing. Many daily tasks must be done as well, such as taking care of the house or yard.
If you are unable to do the things that you enjoy or do the things that you need to do to take care of yourself from day to day, without having significant pain and discomfort, that’s another reason to think about and consider shoulder replacement surgery.
What Does Shoulder Replacement Surgery Entail?
The basic concept with shoulder replacement surgery is similar to hip and knee replacement surgery. I make an incision and go through the muscle layers to access the shoulder joint.
The cartilage on an arthritic shoulder joint is worn down. There are generally bone spurs, and the changes in the shoulder joint that have occurred as a result of the arthritic process create a lot of friction. This is what results in pain and irritation, inflammation, and stiffness.
I remove the bone spurs, remove the arthritic surface of the humeral head, and replace it with an implant with a smooth bearing surface.
Next, on the socket or glenoid side, I also resurface that with an implant so that now there is a nice, smooth bearing.
The soft tissues are repaired, and the surgery itself is pretty much over.
Once everything is healed, your shoulder should have a functional range of motion. Additionally, there should be a significant reduction in your pain.
How Long Does Shoulder Replacement Surgery Take?
Generally speaking, shoulder replacement surgery takes about an hour to an hour and a half to accomplish.
The surgery can vary in the length of time it takes, depending on some of the factors specific to each patient. For example, if a deformity or previous injury needs to be addressed in conjunction with the procedure.
But for the most part, 60 to 90 minutes is about average.
How Long Is Recovery From Shoulder Replacement Surgery?
Recovery from a shoulder replacement can vary. We look at different milestones when we’re talking about the rehab process after a shoulder replacement.
In the beginning stages with initial healing, I primarily focus on how skin incision is healing. That way, we ensure that we don’t need to be concerned about infections or immediate complications.
Then, and very importantly, we need the soft tissues around the shoulder joint to heal, namely the rotator cuff. During surgery, the rotator cuff is released in order to access the shoulder joint, and that tendon takes roughly 12 weeks to heal. Nothing can really be done to speed that healing process up, so it is a protected time after the surgery, where we begin moving in very gradual phases to regain the range of motion.
The strengthening component starts around the 12-week mark.
For really simple activities, the rehab is generally around three months.
When it comes to more complex or aggressive activities, you’re looking at between 3-6 months, depending on how long it takes for you to regain your strength and endurance to enjoy those activities you want to pursue.
Every person is going to recover a little bit differently. I will say that the effort you put forward in the rehab process determines how quickly you can expect to get back in the long run to the activities you enjoy.
How Painful Is Total Shoulder Replacement Surgery?
One of the reasons I like the procedure is that pain relief is pretty predictable when it comes to post-op pain and improvement of post-op pain.
The first week is always the worst, just because you have that kind of fresh, initial, surgical type pain. Then it becomes a lot more manageable from that point forward.
It’s not uncommon for pain to fluctuate as you work through therapy. The more active you are with therapy or when you reach a new plateau and attempt to advance to the next level of rehabilitation, the more temporary discomfort you may experience.
Overall, compared with other shoulder operations, such as a rotator cuff repair or a fracture repair, my patients who have had shoulder replacement surgery tend to progress faster and experience better or more predictable pain relief after surgery.
Can I Lift Weights After Shoulder Replacement Surgery?
After shoulder replacement surgery, it is okay to lift weights.
The thing to keep in mind is that even though today’s implants are great, they are not indestructible. So over the course of the lifetime of the implant, you can wear it out. What typically wears out the first is the plastic component used to create the smooth bearing surface. The more you lift or, the heavier lifting you do, the more wear will be on the glenoid component.
As a shoulder surgeon, I want people to get back to doing the things that they enjoy. So my recommendations are for people to exercise caution, practice safe lifting techniques, and avoid heavy, overhead lifting. There isn’t a specific weight limit, but you want to exercise common sense and avoid doing things that will put you in a position to wear out that bearing surface at a faster rate.
