General Information

DEFINITION--Arthro = joint; plasty = surgical shaping or alteration of. Surgery on an injured or diseased shoulder to re-establish a movable joint.

BODY PARTS INVOLVED--Shoulder joint; muscles, ligaments, bones, cartilage and bursa forming the shoulder joint.

REASONS FOR SURGERY--Diseased or injured shoulder causing chronic pain or disability impairing the quality of life. Disorders treated include rheumatoid arthritis, osteoarthritis, rotator cuff arthropathy, avascular necrosis, congenital defects, old trauma and failed shoulder prosthesis.

SURGICAL RISK INCREASES WITH

• Obesity; smoking.
• Excess alcohol consumption.
• Recent or chronic illness.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Orthopedic surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: X-rays of joint; joint aspiration (to check for active infection); blood and urine studies.
• During surgery: X-rays.
• After surgery: X-rays.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made into the affected shoulder.
• The surgeon will do any repair work needed, remove tissue fragments, reattach tendons to bones and muscles, stitch or staple torn tissue.
• A total shoulder replacement may be necessary for severe shoulder disability. One type is designed to maintain and reproduce the normal anatomy of the shoulder joint. Another type may be used if there is rotator cuff damage that cannot be repaired.
• The incision is closed with stitches and bandaged. The shoulder is immobilized in a sling, splint or cast that is left on for 2 to 3 weeks.

POSSIBLE COMPLICATIONS

• Excessive bleeding; blood clots.
• Surgical-wound infection.
• Accidental fracture of the shoulder bones.
• Failure or loosening of the components of the shoulder replacement.
• Formation of bone in areas where there should be none.

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 6 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.

> You may use non--prescription drugs, such as acetaminophen, for minor pain. Avoid aspirin.

> As prescribed and directed by your surgeon and physical therapist. Passive exercises can begin 3--

6 days after surgery. A sustained rehabilitation program is important to regain as much shoulder mobility as possible.

• Avoid very active sports such as tennis, skiing, swimming or contact sports.

DIET

• No special diet.
• Vitamin and mineral supplements (sometimes).

Call Your Doctor If

> Pain, swelling, redness, drainage or bleeding increases in the surgical area.