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All types of shoulder replacements are done as an inpatient procedure with one night stay in the hospital. The arm is rested in a sling and length of the incision does not give a clue to the type of work done inside the shoulder.
The operation is usually performed under a general anaesthetic and is usually supplemented with a nerve block injection to minimise the pain levels felt immediately after the surgery.
The operation is performed with the patient lying on their back in a ‘deck-chair’ position. The shoulder joint is approached via 7 to 10 cm cut in the front of the shoulder. The tendon is carefully dissected off the capsule and the capsule is then opened to reveal the arthritic bone. Any extra and over grown bone (osteophytes) or ‘loose bodies’ are removed and the arthritic joint is exposed. Appropriate soft tissue releases are done. .
Depending upon the initial plan, the appropriate joint replacement is carried out. The balance of the tissue is assessed and adjusted. The muscle is then reattached with strong sutures. It is important that this repair is looked after well following surgery and protected until it heals with a help of sling and adhering to the advice given by the therapist.
The wound is closed with sutures and a water resistant dressing is applied which may be covered with a further layer of pressure dressing if required. The arm is then placed in a sling. You will be given information regarding wound care and information regarding various exercises you need to do. Physiotherapy will be arranged if required.
Shoulder replacement surgery can be very painful during the post-operative phase and the painkillers will only subdue the pain and will not fully abolish it. It can take a week or two for the pain to come under full control. The level of pain is usually proportional to the amount of work that was done inside the joint.