A shoulder replacement can help restore function and decrease pain in your damaged shoulder joint. While minimally invasive surgical techniques can shorten the recovery time, there still is a period of convalescence. If you are recommended to have your shoulder replaced, be sure to discuss what to expect during and after surgery with your orthopedic surgeon.
Let’s explore the common challenges that patients experience after shoulder replacement.
Whether a traditional or a reverse shoulder replacement, the operation still involves making an incision on the front of the shoulder and removing the humeral head (the ball), and replacing it with a new ball and socket made of metal and plastic. The pain is typically worse in the beginning and then gradually subsides. Pain medicine is often needed for the first week or so. The new long-acting nerve blocks have been very successful at eliminating the initial bad pain and allowing the patient to better manage the discomfort. The pain is often worse when lying down thus making the use of a recliner helpful for the first few weeks. Taking two 25mg tablets of Benadryl with pain medication is often helpful for nighttime discomfort and allows for better sleep. Patients can usually switch to over-the-counter analgesics within a week or so from surgery.
Patients are encouraged to start moving the shoulder as soon as the nerve block wears off. Moreover, physical therapy usually starts within a week of the procedure. The first 6 weeks are critical in getting the bulk of the final motion obtained. Because of this, unlike most surgeons, Dr. Stchur is extremely aggressive in getting the patient using and moving the shoulder. If the shoulder is allowed to freeze, getting the motion back later on is very difficult. A sling is typically used for comfort the first 2 weeks post-op but is not a requirement. The only motion that is not recommended is excessive external rotation for the first few weeks. Typically, a good functional range of motion is ultimately achieved. Some loss of reaching up behind your back is to be expected.
A daily dressing change is recommended for the first 5 days after surgery. Once there is no drainage seen on the dressing then it can be left open to the air. There will be a series of zip ties seen directly on the skin, these must not be removed. They will be removed by your caregiver at about 2 weeks. A shower can be taken once there is no longer any blood on the dressing, usually post-op day 5 or 6. The wound however should not be allowed to contact either pool or ocean water until greater than 2 weeks out.
The patient is allowed to start driving again once off pain medicine and when they feel confident enough to use the arm…typically 2 or 3 weeks post-op.
Shoulder replacement has a very low complication rate but they nonetheless can still happen. The two that can be seen early after surgery are infection and dislocation. Infection typically will present in 7 to 10 days after surgery and presents as redness and tenderness at the wound edge. It is important to alert your surgeon immediately if this is seen. IV antibiotics are given at the time of surgery to help reduce the risk. (We currently tout a less than 1 % infection rate. )
Dislocation will present as an increase in pain, loss of motion, and a ‘lump’ is seen on the front of the shoulder. This too requires immediate notification of the surgeon.
Shoulder Replacement with Dr. Stchur
Dr. Stchur is currently performing nearly 1,000 shoulder surgeries per year with over 400 being in the form of shoulder replacement, most of which is reverse shoulder replacement. This has made him one of the busiest shoulder surgeons in the country. Because of his vast experience, he is much faster than most surgeons which help lower complications such as infection. An average reverse shoulder will be performed in about 30 minutes.
He is affiliated with the Tampa Bay Rays and is passionate about accelerated recovery times and patient outcomes. With a fellowship and board certification in sports medicine, he understands that function is critical to patient well-being. When it comes to shoulder surgery there is a clear choice…come see “The Shoulder Guy”!