Shoulder Replacement

Shoulder replacement is an inpatient surgery that is used to treat a wide variety of shoulder conditions. There are several types of shoulder replacement: anatomic total shoulder replacement, reverse total shoulder replacement, and partial shoulder replacement.

Access a printable version of our joint replacement book here.

Access a printable version of our joint replacement class powerpoint here.

Before Your Shoulder Replacement

If you need shoulder replacement, this is both positive and stressful time. While it is good to know that something can be done to relieve your pain, often there are concerns about what to expect during and after the surgery.

At SSM DePaul, the Joint Replacement Center staff is expertly trained and focused on ensuring that the experience for you and your family is a smooth and positive one. Dr. Burns and the team work hard to ensure that everything runs smoothly before, during and after the surgery.

Before the surgery, preoperative testing is necessary to ensure that you are ready and healthy enough to undergo a surgical procedure. This involves complete x-rays of the shoulder, a CT scan or MRI, bloodwork and an EKG. Dr. Burns requires medical evaluation and involvement of your primary care doctor. Depending on your health, this can be a rather simple or quite involved process to prepare you for surgery. The preoperative testing center coordinates this process.

The Week Of Your Shoulder Replacement

You will have a preoperative appointment with Dr. Burns. This will be an opportunity to ask any questions you may have before surgery. Dr. Burns and her staff will also confirm that all lab work, clearances, and pre-certifications have been completed.

One week before surgery: Stop taking aspirin, ibuprofen, NSAID medications, and any other medications as instructed by Dr. Burns or the hospital staff.

Three days before surgery: Take Tylenol 1000 mg three times a day for the three days prior to surgery. This will help reduce pain and your need for stronger pain medication after surgery.

Night before surgery: Do not shave any area of your body the day before and the day of surgery. Do not eat anything after midnight. You may drink clear liquids up until 2 hours before your arrival time. Do NOT drink anything within 2 hours of your scheduled arrival time.

Pre-surgery bathing instructions: Chlorhexidine antibacterial soap will be given to you at your pre-surgical testing appointment. You can also find this soap in the drugstore. If you are allergic to chorhexidine, use liquid Dial Antibacterial soap. Shower with chorhexidine the night before and/or the morning of surgery before you come to the hospital. For detailed instructions on how to shower with the antibacterial wash, click here.

The Morning of Your Shoulder Replacement

On the day of surgery, you will check in 1-1/2 hours ahead of the planned procedure. The surgery usually takes 1-2 hours. This may be longer if the planned surgery is complex or a revision (redo) surgery. The surgical team will keep your family advised of your progress during your surgery.

An IV will be placed and the anesthesia team will give you a shoulder nerve block by injecting numbing medicine at the base of your neck before your surgery. This medicine makes your shoulder and arm numb and weak for 12-24 hours after surgery. This is the same type of medication that is used by your dentist. Most people cannot lift or move their arm while the block is working. The shoulder block usually lasts around eight hours, which will decrease your anesthesia requirements and reduce postoperative nausea and vomiting. The block also will provide good postoperative pain relief during your overnight stay.

After your procedure is completed, expect to have your shoulder bandaged and elevated. Your arm will be placed in a sling. The incisions will be stitched with absorbable stitches and taped with steri-strips. You will have a waterproof and antibacterial dressing that you may leave in place for 7 days.

After your surgery is completed, you will spend about one hour in the recovery room where your blood pressure, pulse, respirations, and temperature will be closely monitored. When you are stable and comfortable, you will be taken to your room at the Joint Replacement Center.

Typically patients stay overnight in the hospital in the Joint Replacement Center, which is on the main level of the hospital. Your family should use parking lots 5 or 6 to quickly access the Joint Replacement Center. The physical therapists will begin working with you the next day to ensure you are ready to go home. You may stay longer depending on your pain level, your medical status, or if you use a walker or other support to walk.

If you need to weight bear on your arms with a cane or walker, you can begin to do that after 3 weeks. If you cannot walk or safely get around without your walker, you may need to consider staying at a skilled facility for 3-4 weeks until you can safely bear weight on your new shoulder replacement. Be sure to discuss this with Dr. Burns.

At Home After Shoulder Replacement

Most people need some family support at home for the first few weeks, including meals, groceries, or household help. However, since many patients have been functioning with a painful or limited shoulder before the surgery, often they are able to return to routine activities at home postoperatively. Shoulder replacement patients do have to wear a sling and sleep in a sling for 3 weeks after surgery. Patients are considered “home bound” for the first 3 weeks and should not leave home or drive except for doctors’ appointments and a few other approved reasons.

Your arm will be placed in a sling after surgery. You can slip your arm out of the sling intermittently to move your elbow, wrist, or hand. You should do the prescribed shoulder exercises given to you by the physical therapist.

You should apply ice to your shoulder (20 mintues on, 20 minutes off) for the first 48 hours and then as needed for pain and swelling.

You should elevate your shoulder to reduce pain and swelling. Many people prefer to sleep in a recliner or propped up on pillows in bed.

You should take Tylenol or opioid pain medication as needed for pain. Opioid (or narcotic) pain medication such as Norco or Percocet is prescribed after surgery. Most patients only require opioid pain medication for the first 1-2 weeks after surgery, and then only rarely (at night, or after therapy). It is important to understand that opioid pain medication is addictive, and by accepting a prescription with Dr. Burns, you agree to use them responsibly.

You may be able to take celecoxib or an anti-inflammatory medication to reduce pain and swelling. NSAID (anti-inflammatory) medications can interfere with healing of tendons to bone, and Dr. Burns recommends avoiding celecoxib for the first 3 weeks after anatomic total shoulder arthroplasty, which requires rotator cuff healing to bone to work properly. Celecoxib is routinely used after reverse shoulder arthroplasty and hemiarthroplasty, and has been shown to relieve pain and reduce the need for opioid pain medication.

After 3 weeks, you will have your first follow-up appointment with Dr. Burns. Dr. Burns or her physician assistant will x-ray your shoulder and answer any questions you may have. After this visit, you can return to driving and everyday activities as you feel comfortable. Not everyone will want to start driving exactly at 3 weeks, and many people take their time until they feel comfortable controlling a car. Therapy will switch to an outpatient clinic, unless you continue to be “home bound” due to limitations. By 3 months after surgery, most patients have completed therapy and have returned to a normal daily routine.

If you have any questions, you can contact Dr. Burns or her staff with questions at 314-291-7900.