Total Shoulder Replacement Surgery

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Total Shoulder Replacement Surgery

Information Leaflet

Hospital Contact Information:

• Sulis Hospital: 01761 422222
• Bath Clinic Circle Health Group: 01225 809343
• St Joseph’s Hospital: 01633 820344

Introduction

This booklet provides guidance to complement the advice of your Orthopaedic Consultant and Physiotherapist. It does not replace professional medical care. Individual variations may require specific instructions not mentioned here.

Shoulder replacement surgery effectively restores comfortable, functional shoulder movement, though some limitations, such as overhead or behind-the-back motion, may persist. Recovery milestones:

• 3 months: Perform most basic functional tasks.
• 9–12 months: Achieve the full benefit of surgery.

Anaesthesia

The procedure typically combines a regional nerve block with a light general anaesthetic or sedation:

• Regional Nerve Block: Numbs your shoulder and arm for surgery and provides pain relief for up to 24 hours.
• Recovery: Most patients can go home the day after surgery.

Post-op Effects:

• Numbness and limited arm movement for 12–24 hours (normal).
• Further anaesthetic details will be provided pre-surgery.

Pre-Surgery Considerations

Pain Management

• Post-surgery pain is manageable with prescribed medication:
  • Regular medication: Paracetamol and NSAIDs.
  • Optional stronger medication: Codeine phosphate if needed.
• Ice packs: Use for 20 minutes every 2 hours (avoid direct skin contact).
• Contact the hospital for persistent pain or issues.

Wound Care

• Stitches removal: Arrange with your GP for removal after 10 days.
• Keep the wound dry; dressings are splash-proof for short showers.
• Avoid deodorants, talcum powder, or perfumes near the wound.
• Signs of infection (redness, heat, increased pain) require immediate contact with the hospital.

Use of Sling

• Duration: 3–6 weeks, based on individual recovery.
• Remove only for hygiene or exercises. Seek assistance when adjusting.

Activity Guidelines

Activities of Daily Living

• Avoid actively lifting the arm for the first 3–6 weeks; perform only assisted movements for hygiene or prescribed exercises.
• Follow these dressing and hygiene tips:
  • Dressing: Put clothes on the operated arm first; remove them last.
  • Washing: Lean forward to allow gentle arm movement for washing and drying underarm.

Gradual Progression: Three Strategies

1. Safe Zones: Begin with movements in the green zone, progressing to yellow and red zones as comfort improves.
2. Pacing: Use your arm for short periods (30–60 seconds) and gradually increase activity based on tolerance.
3. Soreness Rules: Adjust activities according to pain levels:
   • Fine: Increase activity by 10–20%.
   • Manageable discomfort: Maintain current activity level.
   • Painful: Reduce activity by 10–20%.

Returning to Normal Activities

• Driving: 6–8 weeks post-op, after sling removal and regaining arm control. Notify your insurer.
• Work:
  • Non-manual work: 6 weeks.
  • Light manual work: 10–12 weeks.
  • Heavy manual work: 12–24 weeks.

Post-Operative Care

Physiotherapy

• Outpatient sessions start 2–3 weeks post-surgery, arranged by the hospital Physiotherapist.
• Initial exercises begin once nerve block effects wear off.

Orthopaedic Clinic Follow-Up

• Scheduled between 6–12 weeks post-surgery.
• Contact the hospital for concerns or earlier reviews.

Post-Op Undergarments

• Choose comfortable, easy-to-wear bras such as strapless, racerback, or front-fastening styles.

Post-Operative Exercises

Gentle Mobility (While in Sling)

1. Neck: Bend head forward, sideways, and rotate (4–5 reps).
2. Shoulder Blades: Roll forwards and backwards (4–5 reps).
3. Elbow: Bend and straighten elbow, rotate palm up/down (4–5 reps).
4. Wrist & Hand: Bend wrist, stretch fingers, and make a fist (4–5 reps).

Specific Shoulder Exercises

• Passive Forward Flexion: Lean forward, allowing arms to move gently away from the body. Hold for 3 seconds, repeat 4–5 times.
• Passive External Rotation: Use the non-operated arm to guide the operated arm outward. Hold for 3 seconds, repeat 4–5 times.

Signs to Seek Help

• Fever or temperature.
• Increased pain, redness, swelling, or severe bleeding.
• Persistent numbness in arm/hand after 72 hours.
• Difficulty passing urine.
• Concerns about medication or surgery.

Recovery Timeline

• 3 Months: Significant improvement in shoulder function.
• 9–12 Months: Achieve optimum recovery.

Please return the Outcome Questionnaire at one year post-surgery to help us evaluate the procedure and services.

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