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What to Expect During Shoulder Replacement Surgery

Knowing what’s going to happen during surgery may help you mentally prepare. Dr. Sperling shares what you can expect during a ‘typical’ shoulder replacement.

The thought of having a shoulder replacement can be daunting. However, there have been dramatic advancements in anesthesia as well as surgical techniques that have made going through the procedure easier than in the past with increased attention on post-operative pain management.

In essence, a shoulder replacement surgery simply replaces the parts of your shoulder that are worn out and uneven with new smooth surfaces. These damaged parts of your shoulder are replaced with metal and medical grade plastic. With the development of newer bone preserving implants and techniques, the actual amount of bone removed has decreased over the last several decades. In addition, the number of implant sizes available gives your surgeon the ability to better match your anatomy. 

With any surgical procedure, there are associated risks. Click here to learn more.

The length of surgery can vary, but on average a shoulder replacement takes from 1-2 hours. Below are some general guidelines; however, you should discuss specifics of your individual case with your surgeon.

10 Things to expect during shoulder replacement surgery

1. Generally, you won’t be able to eat or drink after midnight in preparation for surgery. It’s also essential to discuss any specific medications you should or shouldn’t take prior to surgery with your care team and at what point you should stop taking said medications.

2. You will likely need to arrive a few hours before surgery for the check-in process. This will include filling out paperwork, signing forms, changing into a gown, and any other preparation your care team recommends.

3. An intravenous tube (IV) is inserted in your arm to administer fluids and medication.

4. There are several options available for anesthesia. You will discuss these with your anesthesia team. The course of treatment will be based on your medical history, your preferences, and the preferences of the anesthesia team and surgeon.

5. After arriving to the operating room and given anesthesia, your shoulder will be cleaned with a sterile solution and sterile drapes will be applied to your arm.

6. An incision is typically made over the front of your shoulder. Specialized instruments are used to carefully remove the damaged joint surfaces and replace them with implants. The specific type of replacement you undergo will determine the specific type of implants used.

7. After surgery is complete, the surgical site is closed in layers. A sterile dressing is applied and a sling is typically placed.

8. You’re then taken to a recovery room, where you’ll be carefully monitored. The majority of patients spend 1 or 2 hours in the recovery room; however, this varies based on how quickly you awaken from anesthesia.

9. Pain is normal after shoulder replacement surgery. However, the anesthesia team has a wide variety of agents to help with your discomfort in the recovery area. You should discuss with your surgeon their plan for post-operative pain management as well as expectations. Some surgeons use a one-shot, pain block in the joint once surgery is complete, before you wake up. Others may use a catheter. Some prefer not to use a block or shot at all. Make sure you understand your surgeon’s plans for pain management before your surgery.

10. After you are fully awake, you will go to your hospital room and in most cases you will be up and moving that day. Many patients are even able to go home that same day

While every surgery will be tailored to your needs by the surgeon, this is a general framework of events surrounding a standard procedure.  

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  1. Samuelsen, B., et al. (2017, Jan). Primary reverse shoulder arthroplasty in patients aged 65 years or younger. J Shoulder Elbow Surg. 26(1):e13-e17.
  2. Kang, J., et al. (2019, Jun). Primary reverse shoulder arthroplasty using contemporary implants is associated with very low reoperation rates. J Shoulder Elbow Surg. 28(6S):S175-S180.

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