results vsrisks of the procedure

Results

If your rotator cuff is still intact, a shoulder replacement prosthesis can last you between 10 and 20 years.

The reverse shoulder replacement procedure may be a better option if you have complex problems or if you’re aged over 75 years.

The success of your surgery depends on the technical expertise of your surgeon and your motivation to do your rehab exercises after surgery so you can achieve a good range of motion without discomfort.

Risks

As with any medical procedure, there are some potential risks. The chance of complications occurring depends on the exact type of procedure you’re having and other factors including your general health and whether you smoke.

Infection

Approximately 0.5–1% (1 in 100) patients develop infection of the joint following surgery. In some cases, infection is limited to the skin and soft tissues and may only require antibiotics. It’s more problematic if the joint becomes infected. If this happens, you’ll almost certainly need surgery to remove the prosthesis plus IV antibiotics. All going well, at a later stage a second replacement may be inserted.

Bleeding and vessel injury

Blood loss during surgery is usually moderate. However, your surgeon may recheck your haemoglobin level after surgery to determine whether you need a blood transfusion.

Stiffness

This is normal and is due to the initial swelling. Because you’re unable to move your shoulder at first, this can also contribute to stiffness. It usually resolves in a few weeks but regular exercise is essential during your recovery to prevent further stiffness.

Nerve injury

Nerve injury during surgery occurs occasionally. It usually resolves spontaneously over days, weeks or occasionally months.

Rotator cuff injury

Because some shoulder replacement surgeries involve cutting through the rotator cuff tendon, it can be damaged and weakened. If this happens, it may require later repair.

Blood clots

After surgery, blood clots may develop in the veins of your calf. Sometimes the clots travel to your lungs and cause a pulmonary embolism, which may be fatal in rare cases. To prevent this, your surgeon may prescribe some blood thinning injections after the surgery. You may be given compression stockings and/or a machine that compresses your calves. If you smoke or you’re obese, the risk of getting a blood clot is increased.

Loosening and implant failure

While a total shoulder replacement often lasts between 10–20 years, components may loosen or, in the case of the plastic cup, wear out. If this happens, you’ll need a second surgery. While reoperation is rarely needed in the first 10 years, the likelihood of needing further surgery rises gradually from about the 10-year mark.

Dislocation

A shoulder replacement can dislocate if the ball comes out of the socket. The risk is greatest soon after surgery because the tissues are still healing around your new joint. But you’ll always have a slightly increased risk of dislocation. Your physiotherapist will teach you how to avoid activities and positions that could cause dislocation. If it happens more than once, you may need another surgery to make it more stable.

Scar irritation

Your scar can be sensitive or have a surrounding area of numbness. This normally decreases over time and doesn’t affect the joint.

Ask your surgeon about the results and risks associated with your procedure. Also ask about their own rates of patient satisfaction and the rate of complications following the procedures they’ve performed.