Candidates should have severe shoulder pain that interferes with everyday activities, and should have exhausted nonsurgical pain management techniques such as rest, physical therapy, cortisone injections, and anti-inflammatory and pain medications. Typically, patients are younger and are reluctant to undergo a total shoulder joint replacement due to the likelihood the prosthetic will wear out in 10-15 years.
- Pain is typically caused by:
- Osteoarthritis (wear and tear of the joint due to age)
- Rheumatoid arthritis
- Rotator cuff tear arthropathy (a type of wear and tear that develops over time after the rotator cuff is damaged)
- Avascular necrosis (bone death due to lack of blood supply)
Candidates who have not yet exhausted nonsurgical treatment options for severe shoulder pain are not good candidates for shoulder resurfacing. For older patients or those with more severe arthritis, a total shoulder joint replacement may be a more suitable option.
Like other surgeries, shoulder resurfacing requires a complete physical examination with your primary care provider and/or orthopedic surgeon prior to surgery. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with general surgery procedures such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior to surgery. You may need to stop taking blood thinner medication if you are on a regular dose of drugs such as Warfarin (or other blood thinners). You will likely be asked to stop eating or drinking the night before surgery.
Shoulder resurfacing may require a short hospital stay. Immediately after your procedure, your doctor will prescribe medication for pain relief and possibly antibiotics to prevent infection from occurring. In the case of regional anesthesia (numbing the area between your neck and the end of your torso), you may not be able to move your shoulder and hand, your eyelid may droop, and you may feel numb in your shoulder and hand for 12-20 hours after the surgery. This is normal. In the first few days after surgery, keep your shoulder in the cuff or brace provided and apply ice to relieve swelling and prevent further inflammation. Ensure your incisions are kept clean and dry, and follow your surgeon’s instructions in regards to bathing, changing the dressing, and follow-up visits.
You can expect to wear a sling and refrain from driving for 2-4 weeks. Although you will be able to eat, drink and dress yourself, avoid making any abrupt movements with your shoulder. A formal physical therapy program (beginning a week after surgery) will also help you as you learn exercises to maintain a pain-free range of motion. After about 6 weeks, you will most likely be able to return to work and resume most normal activity, depending on the level of physical activity involved in your job.
As with any surgery, there are risks of complications related to infection or adverse reactions to anesthesia. Other known complications include blood clots, bone fracture, joint dislocation/shoulder instability, rotator cuff tearing, fracture, and loosening of the prosthesis, although these are relatively uncommon. Revision surgery or conversion surgery to total shoulder joint replacement is also possible.