Total Shoulder Replacement
Anatomic Total Shoulder Replacement (A-TSR) is an operation to treat arthritis of the shoulder. For this operation to work and last for a number of years, the tendons (rotator cuff) around the shoulder must be intact and functioning. For this reason, not everyone with shoulder arthritis can have an A-TSR. If your rotator cuff is not functioning properly & you require a shoulder replacement, you will more than likely be offered a reverse polarity total shoulder replacement (rp-TSR).
You will normally be admitted on the day of surgery unless you have any specific medical complaints that require prior admission. You will be seen by a nurse, a doctor and maybe a physiotherapy before you go to theatre for your surgery; you will have opportunity to ask any further questions prior to the operation. The anaesthetic time and operation lasts around 2-3 hours. You will be asleep under general anaesthetic and may also have a nerve block to control your pain after the surgery. During the operation we replace the diseased and painful parts of your shoulder joint (the ball with metal and the socket with a hard plastic).
On the morning following surgery you will have an x-ray of the shoulder to check for any fractures we may have caused but not noticed and that the new shoulder is in the correct position. During the x-ray your arm may be moved; do not worry these are the views we need to get to ensure the images are accurate. We will look at the x-rays before your discharge. You may require blood tests after your surgery, though this is not always the case. The physiotherapists will arrange followup and tell you what you can and can’t do with your shoulder. Most people will go home on the first day following surgery but we will never discharge you until you’re safe.
The general complications include bleeding, infection, stiffness and ongoing pain.
Specific complications with this procedure include:
dislocation of or fracture around the new shoulder prosthesis
nerve injury (2% but most recover fully)
loosening of the prosthesis requiring further surgery
Overall between 85-90% of individuals have a good or excellent outcome one year following surgery. Pain can improve up to two years following surgery but you still may have a small amount of pain permanently. Range of movement is a little unpredictable following surgery but it is unlikely to be worse than your current range of movement. We try to perform outcome scores at 3 months, 6 months, 1 year and 2 years following your surgery; this is to let us know how well you’ve done in relation to regional and national averages.
We will normally see you in a follow up clinic at 2 weeks to check for early complications and then at frequent intervals with x-rays to check the shoulder continues to function well.
National Joint Registry (NJR)
The NJR records data about your shoulder replacement to track the implant and see how well it performs, to enable us to continue to improve the level of care we provide. We also ask you to provide certain personal details (with your consent) to match your implant to you and follow it through in the long-term. To see more about how the NJR functions, click here.
For more information from the NJR about Shoulder Replacement click here.
Mr Sam Vollans
Consultant Orthopaedic Surgeon
I graduated from the University of Leeds and completed my specialist training in Yorkshire. Following this, I undertook further training in both elective and trauma shoulder & elbow surgery in Sheffield & Europe.
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