Shoulder replacement surgery is an opportunity for us to eliminate pain an individual that's
suffering from pain from an arthritic joint. So for those that have substantial or end-stage
arthritis of the shoulder those patients may be candidates for shoulder replacement however
not everybody that has shoulder arthritis needs surgery we oftentimes used non-surgical modalities
such as anti-inflammatories rest and cortisone injections if they fail conservative care we
oftentimes will have a surgical discussion about shoulder replacement surgery for patients with
arthritic shoulder depending on which type of problem you have either substantial arthritis
with an intact rotator cuff or arthritis with an irreparable rotator cuff that leads to the
decision making process and determining if someone will require either a total shoulder replacement
or a reverse total shoulder replacement total shoulder replacements are best for patients that
have substantial or end-stage arthritis in lieu of a normal functional rotator cuff essentially
what a patient has done is they have a new ball or new socket placed where the old ball
and socket was arthritic or degenerative a reverse shoulder replacement on the other hand is best for
individuals with an either irreparable rotator cuff or a torn rotator cuff in the setting of
bad arthritis in this particular procedure the ball and the socket is also resurfaced but in a
different fashion we've take the ball and we fix it on the socket and the humerus becomes
concave and that humerus bone will rotate around the fixed socket and both tend to work well for
the appropriately selected patients before the surgery our job is give patients the adequate and
appropriate mount of information to understand exactly what's going to happen that day so
the pre-admission testing team is an excellent support staff that we are fortunate to have at
Northwestern once we've received notification from the surgeons office we contact the patient to set
up any testing that needs to be done this would include things like chest x-rays lab work and EKGs
the preoperative testing department will go over things and discuss the procedure what to expect
and answer any questions the patient is called the night before to be notified what time their
surgery is and what time they need to arrive at the hospital patients having shoulder surgery will
need to wear something loose preferably button-up that is easy to put on after surgery on the day of
the surgery the patient checks in at the front counter it meets the staff there to get their
paperwork ready for the operation the patient will be seen by the surgeon who will be performing the
surgery at that time we'll discuss the procedure as well as confirm that the informed consent
form that the patient will sign matches with the correct extremity after this the anesthesiologist
will discuss at length of the patient choices and options for anesthesia typically for shoulder
surgery there are two types of anesthetics the patient will receive the first component is a
general anaesthetic that the patient receives in the operating room and a second component
the anesthetic is a nerve block a nerve block is an injection of numbing solution to help render
an area of the body numb nerve block serves two purposes first it can control pain before and
after the operation it usually allows patients to go home feeling limited to no pain because the
anesthetic works for approximately 12 to 18 hours the second benefit is the less pain the patient is
experiencing during the operation requires less general anesthesia so when patients wake up from
the operation the often times go home not feeling nauseated nerve blocks are safe which is why it's
a routine component of our hands that x-4 patient undergoing shoulder surgery in the operating
room usually there are three or four people first there's the anesthesiologist second there's myself
and oftentimes my physician assistant there will be a scrub nurse whose job is to pass instruments
to myself and my physician assistant during the operation for shoulder replacement surgery the
incision is approximately two to three inches once the surgery is complete we'll close the
wound delicately with bio absorbable suture in place a dressing that is waterproof on the area
that'll allow patients to shower that night or the next day patients wake up in the operating
room a lot of times because of the anesthetic they won't remember that the patient is transported
from the surgical suite to the recovery room at which time a surgical post-operative nurse will
take care of them as shoulder replacement surgery is becoming less and less invasive we are pushing
out a little more and more in a safe manner to get patients home total shoulder patients can
expect to go home the same day of surgery or be discharged the day after shoulder patients will
be restricted to one arm after surgery for a while so may need help with chores and food preparation
immediately after surgery it's important to get things set up at home it's important to
have family members help if possible thinking about these things before the operation will
typically make the surgical experience a lot better after surgery patients can return to
driving once they are off pain medications and they feel safe to drive they just need to remove
their sling will utilize the sling for about a month this allows the wound to heal and allow
the muscles to to function again patients were coming into the office approximately two weeks
after the operation for their first post-operative is--it and then we begin formal physical therapy
the goal for physical therapy for the shoulder procedure is really to just begin with gentle
range of motion once we progress beyond that we can start doing some gentle strengthening as well
once we get to there we can go on to the returning to prior level of function stage where we really
go a little bit more aggressive strengthening and get them back to feeling like they were prior to
surgery home exercises for the patient is one of the more important aspects of recovery my advice
for the home exercise is to try to really get into a routine individuals should expect their
shoulder to be pain free and very functional a range of motion will improve after the
surgery in general and individuals should regain approximately 50 to 80 percent of their range of
motion loss after the operation after four to six months we expect individuals to get back to their
normal life in a pain-free environment we will guide that person through the steps to return
to normal functionality we are on the cutting edge in the forefront of orthoscopic and join
replacement surgery at Northwestern when you come to Northwestern you should feel comfortable in the
fact that you're receiving the most innovative cutting edge procedure that is available