Revision shoulder prothesis

Complaints

A revision of shoulder prosthesis means that (part of) your shoulder prosthesis must be replaced. When removing the shoulder prosthesis a part of healthy bone will be lost and in most of the case a larger type with chosen with opportunities for stabilization and fixation of the prosthesis.

Before a revision of your shoulder is necessary, you often suffer from one of the following symptoms:

Your shoulder dislocates
The shoulder is painful
The prosthesis is loose
A bone fracture occurred at the prosthesis

The revision may be needed to treat an infection, followed by a revision months later. In shoulders without infection only loose parts will be replaced.

Treatment

The procedure for shoulder revision prosthesis is as follows:

The surgery is performed under general anesthesia or spinal puncture
Your orthopedist starts in most of the cases using the old scar. Several muscles are stretched aside, and sometimes a tendon is detached.
Then the (old) prosthesis is removed. Depending on the condition of the remaining bone and the expected stability prosthesis is chosen and the shoulder prepared.
Sometimes it is necessary to using bone grafts or other techniques to build bone that is gone.
After a trial fitting of prosthesis, the surgeon places the final shoulder prosthesis
The wound is closed with dissolvable stitches or special staples. A firm pressure dressing provides support for the next 48 hours and prevents a large hemorrhage.

We use the latest technology to minimize tissue damage and the recovery takes place soon after the operation of the prosthesis.

Preparation

Prior to your surgery, you will have a physical examination. You visit the anesthesiologist to determine whether the operation is possible. Besides they will explain the various forms of anesthesia and pain management, both during and after surgery. More information about anesthesia, click here.
The day of surgery is scheduled. The total hospital stay is planned for three days. You arrive on the day of surgery at the clinic. The days after surgery are used to recover and to receive instructions and exercise from the physical therapist.
Usually you do not use your arm the next coming weeks. If you have lack of help at home please discuss this with the transfer nurse of the Vlietland hospital or home care setting of your home.

Day of surgery

On the day of surgery you wear comfortable clothing and shoes. Personal items such as medicines, clothing and toiletries take you. Leave valuables at home as much as possible.

The procedure is as follows:

You appear sober at the hospital
After your medical preparation prior to surgery you will positioned and treated in the operating suite
After surgery you will be moved to the recovery room to recover from your anesthesia
Back on the ward the nurse checks you out.
A shoulder sling positioned to create a restriction of movement

The day after your surgery, the physical therapist will show you how to exercise and walking with crutches

Recovery

The recovery period after a shoulder replacement comprises approx 6 months.

The days after surgery you are still hospitalized. You get pain medication and you start physical therapy immediately with instructions for home practice.
Six weeks after surgery you use a sling to create a restriction of movement
After 24 hours the bandage may be removed from the shoulder.
After one day, the wound dressing will be removed and the wound assessed
The stitches will be removed about 14 days after surgery
After at least 6 weeks you can start with moving the arm slightly, but only after about half year fully recovered. You can drive if your shoulder feels strong and stable enough. The period during which work can be resumed depends on the type of work you do.

Complications

Surgical procedures carry some risk of complications. Complications may be related to anesthesia, for more information, click here.

Consult your surgeon with the following complications:

Bleeding in the knee after surgery
The wound remain sensitive sometimes long after surgery
Instability of the shoulder after surgery
Infection of the shoulder
Prosthesis get loose
Damage to the knee prosthesis structures around the knee, such as nerves or blood vessels

Sometimes the outcome of a shoulder surgery is not what you had expected. Please consult your surgeon.

Important: an infection elsewhere in the body (dental) poses a risk to your prosthesis. Please consult your surgeon or general practitioner

Expectations

Surgery often has good results resulting in lasting pain relief and improved function. The mobility will be reduced compared to the past, but your daily activities can usually perform well. Rehabilitation after getting shoulder prosthesis takes a long time, all together one year. The use of an artificial joint means that you should watch out for infections elsewhere in the body.

Frequent asked questions (FAQ)

I have already had a revision of my shoulder prosthesis had. Could this again?
Yes, if the condition of the bones and muscles / tendons is good, then a revision of the shoulder prosthesis can be performed.

How long takes a shoulder revision procedure?
The average duration of a shoulder replacement session is between 90 and 120 minutes.

Will my shoulder just as mobile as after the first shoulder prosthesis?
Because of additional scarring it may be that the shoulder moves less slightly.

Prepare yourself by reading all the information given. For any questions please telephone or email contact with Orthopedium.