When to consider shoulder replacement surgery

Shoulder replacement surgery, also known as shoulder arthroplasty, is designed to relieve pain and restore function for individuals suffering from advanced arthritis, traumatic injuries, or degenerative joint conditions that have not responded to other treatment such as painkilling tablets of gels, painkilling injections, or physical therapy. 

In Plymouth, we have a group of 3 full-time, experienced, specialist shoulder surgeons who are fellowship-trained, and have more than 50 years of consultant-level expertise between them. We carry out more than 150 shoulder replacements each year, including complex and revision cases referred by colleagues from around the southwest of England. 

The shoulder is a complex ball-and-socket joint with an extensive range of movement, made up of the humeral head (the ball) and the glenoid (the socket). A thin lining of hard, shiny and smooth cartilage over the bones in the joint allows for pain-free movement. In a total shoulder replacement, both of these components are replaced with artificial parts - usually a metal ball (made of surgical-grade stainless steel) and a plastic socket, made of hi-density polyethylene. These are inert and very hard-wearing, and you can expect most shoulder replacements to last a very long time (about 95% are still going strong at 10 years, and 85% at 20 years). 

In some cases, a reverse shoulder replacement is indicated: this is where the relationship between ball and socket is reversed, so that a metal ball is attached to the socket and shoulderblade, and a new socket is attached to the top of the upper arm to replace the ball.  

The operation takes about 2 hours, and if you live within an hour's journey from the hospital and have someone at home to look after you for the first 24 hours, we are very happy to offer you a daycase procedure ie without an overnight stay in hospital; most patients relish the idea of being able to return to their own home and sleep in their own bed! Some patients choose to stay with us overnight for personal or medical reasons, and they are usually able to go home the following day. We have pioneered day-case shoulder replacement surgery in Plymouth over the last 5 years, and follow up with our patients have shown that more than 9 out of every 10 would recommend this approach to a friend.  

You would need to rest your arm in a sling for the first 2 weeks, although you can take the sling off to wash and dress. After 2 weeks, you would start a course of physiotherapy, involving weekly or fortnightly visits to a therapist, plus exercises to do at home every day. Most folk can think about retuning to light duties around the shoulder and driving short local distances after 4-6 weeks, although a full recovery often takes 6 months or more.  

More than 85% of patients undergoing shoulder replacement are pleased with the results. Although shoulder replacement is a very safe operation, it is of course a major procedure and there are some uncommon - but not insignificant - potential risks, including infection, nerve injury, and implant loosening. 

Overall, shoulder replacement can be a life-changing solution for individuals suffering from chronic shoulder pain and restriction. With specialist surgeons and physiotherapists overseeing your rehabilitation and post-operative care, you should soon be able to return to all your daily activities and enjoy a more active, pain-free life.