Shoulder osteoarthritis, chondrolysis, rheumatoid arthritis, degenerative joint disease, and arthritis after shoulder arthroscopy and open surgery
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Saturday, July 05, 2008
Figure 9 - Axillary incision Preparing for surgeryWhat type of preparation needs to take place before shoulder replacement surgery for shoulder arthritis? Total shoulder joint replacement surgery is considered for healthy
and motivated individuals in whom arthritis interferes with shoulder
function.
Successful shoulder replacement depends on a partnership between the
patient and the experienced shoulder surgeon. Patients should optimize
their health so that they will be in the best possible condition for
this procedure. Smoking should be stopped a month before surgery and
not resumed for at least three months afterwards. Any heart, lung,
kidney, bladder, tooth, or gum problems should be managed before
surgery. Any infection may be a reason to delay the operation. The
shoulder surgeon needs to be aware of all health issues, including
allergies and the non-prescription and prescription medications being
taken. Some of these may need to be modified or stopped. For instance,
aspirin and anti-inflammatory medication may affect the way the blood
clots. Since blood transfusion may be necessary, patients may choose to
have a blood bank draw and store their own blood for a possible
autotransfusion.
Figure 9 shows the incision used for a total shoulder replacement.
This area of skin must be clean and free from sores and scratches.
Before surgery, patients should consider the limitations,
alternatives and risks of surgery. Patients should also recognize that
the result of surgery depends in large part on their efforts in
rehabilitation after surgery.
The patient needs to plan on being less functional than usual for
six to twelve weeks after the procedure. Driving, shopping and
performing usual work or chores may be difficult during this time.
Plans for necessary assistance need to be made before surgery. For
individuals who live alone or those without readily available help,
arrangements for home help should be made well in advance. What about the timing of shoulder replacement surgery for shoulder arthritis? How long can it be safely delayed? Shoulder replacement arthroplasty can be delayed until the time that is
best for the patient's overall well-being. However, in cases of
rheumatoid or other types of inflammatory arthritis, excessive delays
can result in the loss of bone and tendon tissue. These losses can
compromise the quality of the surgery and its result.How can the costs of shoulder replacement surgery for shoulder arthritis be anticipated? The surgeon's office should provide a reasonable estimate of:
- the surgeon's fee, and
- the hospital fee.
Who should perform shoulder replacement surgery for shoulder arthritis and where? Shoulder replacement arthroplasty is a technically demanding procedure
that should be performed by an experienced surgeon in a medical center
accustomed to performing shoulder joint replacements at least several
times a month. Patients should inquire as to the number of shoulder
arthroplasty procedures that the surgeon performs each year and the
number of these procedures performed in the medical center each year.How can surgeons experienced in shoulder replacement surgery for shoulder arthritis be found? Because less than twenty thousand of these procedures are peformed
in the United States each year, it is unlikely that every community has
an experienced shoulder arthroplasty surgeon who performs many of these
procedures each year. Surgeons specializing in shoulder joint
replacement may be located through university schools of medicine,
county medical societies, or state orthopaedic societies. Other
resources include local rheumatologists or professional societies such
as the American Shoulder and Elbow Surgeons Society.
In what type of facility is shoulder replacement surgery for shoulder arthritis usually done? Shoulder replacement arthroplasty is usually performed in a major
medical center that performs these procedures on a regular basis. These
centers have surgical teams and facilities specially designed for this
type of surgery. They also have nurses and therapists who are
accustomed to assisting patients in their recover from shoulder
replacement surgery.
Total shoulder joint replacement for shoulder arthritis
Surgery for shoulder arthritis at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-7416 to make an appointment.
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