Recovering from Shoulder Replacement Surgery
After surgery, you will be moved into the recovery room where you will stay for approximately two hours. During this time, you will be monitored until you awaken from anesthesia, at which time you will be taken to your hospital room. Your operated arm will be numb from the regional anesthesia, which also can provide good pain relief for the next day. Another side effect of the anesthesia is that you will not be able to move the fingers or wrist on the operated arm.
Typically, you will stay in the hospital for two to three days, but this depends on each individual and how quickly he or she progresses. After surgery, you may feel some pain that will be managed with medication to make you feel as comfortable as possible. This will be given either by injection or pump and should be used as needed. To avoid lung congestion after surgery, you should breathe deeply and cough frequently to clear your lungs.
A Cryocyff, an icing device that will help control pain and swelling, will be placed on your shoulder in the recovery room. You will be able to bring this device home with you and should use it frequently to minimize any discomfort you experience. In some instances, the insurance company may not approve the use of a Cryocyff, in which case we will use ice packs instead.
Your arm will be in a sling for four to six weeks after surgery. If you have regional anesthesia, it will take 12 to 18 hours to wear off, during which time your hand and arm will be numb. When you are able to move your hand, begin making a fist and holding it for five seconds. This small exercise helps to keep your blood circulating and should be done frequently.
Possible Surgical Complications
Total shoulder replacement is a very successful operation and the 10 year survival rate is up to 90 percent. Many patients end up with extremely functional shoulders and are able to return to the activities of daily living and low impact sports without pain. The operation may have some complications, although they are very rare. Complications may include infection, bleeding, shoulder instability, tearing of the rotator cuff, fracture and loosening of the prosthesis.
Physical Therapy
Arm and shoulder movements are very important for recovery. Usually the first day after surgery, your orthopedic surgeon or another doctor will begin to work with you and teach you specific exercises to regain full arm and shoulder movement.
The doctor will provide you with a list of exercises that you can do to keep your muscles strong without damaging the replaced shoulder. These exercises are necessary to prevent your elbow and shoulder from getting stiff. They will be difficult to perform in the beginning, but will get easier every day. You also will be visited by a physical therapist who will reinforce these exercises while you are in the hospital. During your hospital stay, you will attend physical therapy one to two times a day. An occupational therapist and nurse discharge planner also will help you prepare for your homecoming.
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Post-Hospital Care
You will be discharged from the hospital on the second or third day following your surgery depending on your recovery. Once you have returned home, it is very important to follow your orthopedic surgeon's instructions during the first few weeks after surgery.
Medications
You will be given prescriptions for pain medication, anti-inflammatory medicine and aspirin, which helps to prevent blood clots. Use the pain medication only if you are experiencing pain. Take the anti-inflammatory as prescribed.
Caring for Your Incision
You will have stitches running along your wound on the front of your shoulder. These will be removed one week after your surgery, at your first follow-up appointment. Call your surgeon immediately if your incision swells, drains, becomes red or painful, or if you develop a temperature over 101 degrees Fahrenheit.
Before leaving the hospital, your incision will be covered with a dry bandage. Please do not get the incision wet or dirty. The dressing can be changed daily and it is not uncommon to have a small amount of blood on the dressing. Do not shower or go in the bath until you return for your follow-up appointment. The incision has not healed yet and getting the incision wet puts the shoulder at risk of infection. After the stitches are removed and if the doctor allows you to, you can take a shower and let the water run over the wound. Do not go into a tub or Jacuzzi to soak the wound. Pat the wound dry after you finish showering.
Physical Activity
Being physically active is an essential part of recovery. Continue to perform the exercises you learned in the hospital. Before leaving the hospital, you will be given a physical therapy exercise plan to follow. Within the next three to six weeks, you need to protect the shoulder so that the muscles can heal. You should have an appointment to see a therapist within the first or second week after you are discharged from the hospital. During the first few weeks of recovery, the physical therapist may teach or help you perform specific exercises to strengthen your arm and shoulder.
You may experience swelling and bruising of the hand and arm. This is normal and results from the swelling and bruising from your shoulder, which travels down the arm. Unfortunately, there is no treatment for this, but it is recommended that you bend and straighten your elbow frequently and make a fist to help keep your circulation flowing.
Your arm will still be in a sling and it is recommended that you wear it when you are in public or moving around. If you are reading, watching television or working at a desk, you may loosen it. When you are getting dressed, it is easiest to put your operated arm through the shirt-sleeve first, then put your sling on. You may use your arm to perform normal daily activities, such as eating, writing or shaving, but you may not lift any items or reach out suddenly until you are instructed that it is OK to do so.
Six weeks after surgery, when you regain full shoulder movement, you can probably resume driving. At this time, your surgeon also may allow you to return to work, depending on how much physical activity is involved in your occupation. You will also start to strengthen your shoulder up with physical therapy.
Follow-Up
Please schedule your first post-operative appointment prior to surgery. When you come for your first appointment, you will have an X-ray, so please make sure to come 30 minutes before your appointment time.
During the first year following your surgery, routine follow-up visits will be scheduled with your orthopedic surgeon at one week, two weeks, six weeks, three months, six months and 12 months after your surgery. You will be asked to return for annual visits thereafter to assess the status and function of your implant.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
