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 that you can achieve a good range of motion without discomfort.
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.
Approximately 0.5 to 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. If the joint becomes infected, you’ll almost certainly need surgery to remove the prosthesis plus IV antibiotics.
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.
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 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, weakening it and possibly requiring later repair.
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. In order 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 and 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.
A shoulder replacement can dislocate if the ball comes out of the socket. The risk is greatest soon after surgery, before the tissues have healed 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.
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.