Preparation, Procedure, Precautions & Rehab Protocol For Total Shoulder Arthroplasty

Submitted by Nic on December 2, 2013

Total shoulder arthroplasty (CPT Code 23472) can be described as a surgical procedure used to restore function and comfort to a shoulder that has been affected by joint dysfunction. In this operation, the surgeon will replace the affected shoulder ball with a metallic ball and the socket (glenoid) will be resurfaced with high-density prosthesis.

Any destruction to the joint may cause limited range of motion and extreme pain, which could interfere with your daily activities. Your doctor may suggest that you undergo the total shoulder replacement surgery in case your joint has been affected by conditions like -

Though rare, this procedure may also be considered if your shoulder has been through severe trauma and all other forms of treatment have failed to provide relief.

Preparing for a Total Shoulder Arthroplasty

The total shoulder arthroplasty is usually scheduled in advance, which means that you will know the date and time of your surgery for days.

This will give you the chance to gather as much information as you can about the surgery, which is a must. Preferably set up an appointment with your doctor a few weeks before the surgery so that you can get any of your questions answered. This is the best time to discuss your choice of anesthesia with your doctor.

Certain medication need to be avoided for a few weeks before the surgery and therefore, do let your doctor know about all the medicines you take on a regular basis; you may need to discontinue them for a while. In case you smoke, quit the habit for at least 2 weeks before the surgery is scheduled.

On the actual day of the surgery, try to get admitted in the hospital as early in the morning as possible. Do not eat or drink anything for about 8 to 12 hours before the operation is scheduled to take start.

Since you will probably need to stay at the hospital for a couple of nights, pack your bag accordingly.

Once at the hospital, the nursing staff will prepare you for the surgery, by checking and recording your blood pressure, temperature as well as your pulse.


It is always best to opt for general anesthesia for a surgery of this kind, so that you are unconscious for the entire procedure and do not feel a thing. Once the anesthesia takes its effect, your surgeon will make an incision on the front part of the shoulder and enter the diseased joint after dividing one muscle. The arthritic bone will then be resected from the upper arm bone or humerus. Next, the shoulder socket will be prepared and a plastic liner will be cemented into place. Your surgeon will place a metal ball with a stem down on the arm bone. After that, the rotator cuff muscle will be repaired and your arm will be stitched close. A bandage will also be place over the incision. The entire procedure takes close to 3 hours.

Recovery and Rehab Protocol

Immediately after the surgery, your arm will be placed in an immobilizer for a day, which will be taken off the next day. During your two-day stay at the hospital, you will be taught how to perform simple tasks, without applying any strain to your shoulder.

A physical therapist will also start teaching you the exercises you should practice regularly for the next few weeks and months. The entire recovery process takes about 3 to 4 months and it success it largely dependent on physical therapy. During this time, you may be allowed to drive and perform light physical activities. However, make sure that you avoid anything too strenuous. It is absolutely essential that you schedule regular doctor visits, to check if your progress is on track!


Given below are a few precautionary steps that will need to be followed to the tee during the recovery phase -

  • Do not lift any heavy weight or perform any heavy exercise and wear a sling if it has been recommended by your doctor
  • In case you are planning to undergo any surgical procedure in the future, preoperative and postoperative antibiotics should be used to prevent infections.
  • Get any bacterial infection, however mild, treated with antibiotics immediately. Bacterial can easily spread to the operated shoulder and cause serious problems.

In case you notice any complications like excess pain, bleeding, allergic reactions, blood clots and so on, after the surgery, do inform your doctor about it immediately.


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