Procedure, Precautions, Complications & Recovery of Shoulder Arthroplasty

Submitted by Nic on November 20, 2013

When severe pain in the shoulder starts disrupting your daily activities, you may have to consider surgical options to seek relief. Shoulder arthroplasty, (ICD 9 Code 81.80-81.81) also known as shoulder replacement, is a medical surgery conducted for relieving stiffness and pain in the affected joint.

The shoulder arthroplasty was first performed in the 1950s for treating severe cases of fractures, but over the years, the procedure has been used for other forms of shoulder afflictions, like pain and stiffness caused by arthritis. Data from the Agency for Healthcare Research and Quality shows that around 53,000 people across the US go through this surgery every year.

A doctor may advise you to undergo a shoulder arthroplasty for several different reasons. Some of the most common conditions that are treated with this medical procedure include -

  • Degenerative Joint Disease (Osteoarthritis)
  • Osteonecrosis (Avascular Necrosis)
  • Post traumatic Arthritis
  • Rheumatoid Arthritis
  • Rotator Cuff Tear Arthropathy
  • Severe fractures

Shoulder replacement can be of different types, which include total shoulder athroplasty, reverse shoulder arthroplasty, stemmed hemiarthroplasty and resurfacing hemiarthroplasty. The procedure that you may be advised to undergo depends upon the underlying cause of the pain.

Preparing for a Shoulder Arthroplasty

In case you are scheduled for a shoulder arthroplasty, prepare a list of all the medication you take and show it to your doctor. You may need to discontinue some of these drugs for a few days before the surgery. If you smoke, your doctor could ask you to avoid doing so for a couple of weeks too.

On the day of the operation, avoid eating or drinking anything for 8 to 12 hours before the surgery is scheduled to start.


During the shoulder arthroplasty, a surgeon replaces the damaged parts of the joint with artificial components, known as prostheses. Depending upon the type of surgery you opt for, the doctor will replace just the ball or the ball along with the socket (glenoid).

Before starting the operation, your doctor will give you general anesthesia, which means that you will be unconscious for the whole procedure and won’t feel a thing. You could choose to get regional anesthesia too, so that you remain awake through the surgery without feeling the pain.

Once the anesthesia takes effect, the doctor will make an incision over your shoulder to gain access to the area. After that, the surgeon will -

  • Remove the top or head of the upper arm bone. This is known as the humerus
  • Cement the new head and stem it in place
  • Smooth the old socket surface & cement the new one into place
  • Close the incision with sutures or staples

A bandage will be wrapped around the incision, to facilitate the healing process. Your surgeon may also place a tube in the incision so that the excess fluid accumulating in the joint can be drained.

The entire procedure could take about 2 to 3 hours.


After the surgery is over, you will need to stay in the hospital for about 2 to 3 days. During this time, you may receive physical therapy for the shoulder muscle. The therapist will also teach you how to manage with one good shoulder.

Make sure that you wear the sling for the number of weeks suggested by the doctor. It could take anywhere between 4 and 6 weeks for you to recover from the shoulder replacement completely.

During this time, do not engage in any physical activity, unless it has been Okayed by your doctor. Also practice the exercises that have been recommended by your physiotherapist.


During the shoulder replacement surgery, the subcapularis is detached and later reattached. This reattachment should be well-protected for the next 6 weeks. Therefore, do avoid any strengthening activities that involve internal and external rotation.

Risks and Complications

There are certain risks that are associated with most medical surgeries, such as -

  • Pain
  • Bleeding
  • Formation of blood clots
  • Infections
  • Allergic reaction to the anesthesia

Some of the more severe complications that may arise because of the shoulder replacement surgery include -

  • Adverse reactions to the artificial joint
  • Blood vessel or nerve damage
  • Breaking of the bones
  • Dislocation of the prosthesis
  • Loosening of the implant

Fortunately, most of the complications can be addressed with the help of timely intervention. Do speak to your doctor if you notice any adverse symptoms.


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