PATIENT’S GUIDESHOuLdErHighlights for Patients

The following information is provided about shoulder replacement in general.

It is not intended to provide recommendations regarding your medical care or if shoulder replacement is

appropriate for you. Your orthopaedic surgeon is responsible for all recommendations and decisions about

your medical care if you and your surgeon decide that shoulder replacement is appropriate for you.

The following information also does not provide a complete or full discussion of the specifics of

shoulder replacement surgery; the prosthesis that may be used; your care before, during, and after surgery;

or the potential complications associated with shoulder surgery and your particular condition.

Depending upon your particular condition, some of the general information provided may not be

applicable to you. You will need to discuss the specifics of your case with your surgeon.

Lima Corporate does not guarantee any specific results, recovery or rehabilitation.

WARNING:

Please remember the information on this document is for educational purposes only and should not

be used to make a decision on a condition or a procedure.

All decisions should be made in conjunction with your surgeon and your primary care provider.

The people appearing in the photographs on this publication are models and used for

illustrative purposes only.

This publication is not intended for distribution in the U.S.

DISCLAIMERH I G H L I G H T S F O R P A T I E N T S

as a joint pain sufferer, you’re undoubtedly used

to making decisions dictated by limitations.

unfortunately, the natural shoulder joint can

wear out plus they may be subject to debilitating

conditions such as arthritis, disease, or other

injuries. arthritis and other

debilitating joint conditions

can interfere with just about

every aspect of your life -

from walking, to exercising,

working, enjoying time with family and friends, to

getting a full night of sleep. any surgery is a big

step. medical professionals expect you to have

questions, concerns, hopes and expectations.

The purpose of this guide is to provide you

with more information you need to proceed

with confi dence as to what to expect along

the road to recovery, and what you can do to

maximize your outcomes.

make sure to go over

pertinent information with

your care team as well.

The more you know, the

better prepared you’ll be to take charge of your

comfort and mobility again.

INTRODUCTIONH I G H L I G H T S F O R P A T I E N T S

The shoulders are among The mosT imporTanT joinTs in The human body.

WE BELIEVE KNOWLEDGE AND

PREPARATION AS TO WHAT TO EXPECT

PRE- AND POST- OPERATIVELY WILL

MAKE YOUR RECOVERY EASIER.

YOUR TIMELINE

TheAnatomy

JointPathologies

The Procedure

Recovery after surgery

The Implant

Your New Joint

6 Shoulder THE ANATOMY

THE ANATOMYH I G H L I G H T S F O R P A T I E N T S

The shoulder is a ball and sockeT joinT.

however, unlike The hip iT has far greaTer mobiliTy

and because of ThaT, also less sTabiliTy.

The muscles, tendons and ligaments help support and mobilize the joint.

The main muscles around the joint are the deltoid and rotator cuff muscles.

The bones that make up the shoulder joint are the humerus (arm) and scapula (shoulder blade).

in a normal shoulder the humeral head articulates with the glenoid (part of the scapula) in a smooth

manner as they have a healthy covering of cartilage.

> OSTEOARTHRITIS

Degeneration of joint cartilage and

underlying bone

> RHEUMATOID ARTHRITIS

A chronic progressive disease causing

infl ammation of the joints

> TRAUMA

Fracture of the proximal humerus or arthritis

following a fracture

> ROTATOR CUFF ARTHROPATHY

Condition involving arthritis and an irreparable

rotator cuff

humeral head

delToid

glenoid

roTaTor cuff

JOiNT PATHOLOGIES

8 8Shoulder iNTrOducTiON

iS SHOULDER REPLACEMENTriGHT FOr YOu?

The decision To have shoulder replacemenT surgery

should be a cooperaTive one beTween you, your family,

your family physician, and your orThopaedic surgeon.

There are several reasons why your doctor may recommend shoulder replacement surgery.

people who benefi t from surgery often have:

✓ Severe shoulder pain that interferes with everyday activities, such as reaching into a cabinet,

dressing, toileting, and washing.

✓ Moderate to severe pain while resting. This pain may be severe enough to prevent a good night’s

sleep.

✓ Loss of motion and/or weakness in the shoulder.

✓ Failure to substantially improve with other treatments such as anti-infl ammatory medications,

injections, or physical therapy.

10 Shoulder THE PrOcEdurE

1 whaT is shoulder replacemenT?

The shoulder joint is the third most common joint replaced in the body. The shoulder is a ball-and-socket

joint: the ball (humeral head) of your upper arm bone (humerus) fits into a shallow socket (glenoid).

when this joint becomes worn or painful, your surgeon may recommend a shoulder replacement.

sometimes, only the “ball” is replaced, this is called a hemiarthroplasty. when the “ball and socket”

are both replaced, this is called a total shoulder arthroplasty. The ball is made of metal and the socket

is made of metal or plastic.

THE PROCEDUREH I G H L I G H T S F O R P A T I E N T S

in a normal shoulder The humeral head arTiculaTes wiTh

The glenoid (parT of The scapula) in a smooTh manner as

They have a healThy covering of carTilage.

2 is shoulder replacemenT righT for me?

your surgeon will perform an examination of your shoulder; take X-rays or other electronic pictures to

see if shoulder replacement surgery is right for you. age is usually not a factor.

if you have pain, limited movement, cannot sleep well at night or cannot perform everyday tasks, your

surgeon may recommend shoulder replacement surgery for you.

12

3 Tell me more abouT The acTual surgical process.

shoulder replacement surgery is performed in the hospital by a trained orthopaedic surgeon. commonly,

the procedure takes between 1- 3 hours. an incision is made that is between 8-20 centimeters in length

and is made in the front or side of the shoulder in order to gain access to the joint. The humeral head

(ball) is removed and a metal stem is placed in the humerus (arm bone).

The stem serves as a base for the new humeral head (ball) to sit on. if you are having a total shoulder

replacement, the glenoid (socket) is smoothed and prepared and a metal or plastic component is

attached so that it articulates with your new humeral head (ball).

4 how long will i be in The hospiTal?

you should expect to stay in the hospital between 1-3 days; however it could depend on many factors

and your surgeon will determine this.

5 will my shoulder appear normal afTer surgery?

most patients will have no abnormalities.

you will have a visible scar on the front or side of the shoulder from the incision.

Shoulder THE PrOcEdurE

6 whaT is a “reverse” shoulder replacemenT?

when a patient has a torn or severely weak rotator cuff muscle, your surgeon may recommend a

procedure called a reverse shoulder replacement. The reverse shoulder replacement is similar to a

total shoulder replacement except in a reverse shoulder replacement, the socket and metal ball are

switched. The ball is fi xed to the socket and the cup is fi xed to the upper end of the humerus.

The reverse shoulder replacement relies on the deltoid muscle, instead of the rotator cuff, to power and

position the arm. your surgeon will determine which procedure is best for you.

anaTomicalshoulder

prosThesis

reverseshoulder

prosThesis

resurfacingshoulder

prosThesis

14 Shoulder THE PrOcEdurE

meTal head

wiTh sTem

polyeThylene

polimer sockeT

convenTional shoulder replacemenT

meTal

(or polyeThylene)

sockeT

polyeThylene

(or meTal) glenosphere

reverse ToTal shoulder replacemenT

7 whaT are The complicaTions and risks of shoulder replacemenT surgery?

shoulder replacement surgery is a major operation and while uncommon, there are always risks during

and after any major surgical procedure. some complications can include, but are not limited to, blood

clots, infection, implant breakage, malalignment, dislocation, stiffness, nerve damage and implant

wear. To help avoid complications, your surgeon may prescribe antibiotics or blood thinners prior to

and after surgery. some patients could experience stiffness or pain after surgery. age and activity level

effect longevity of the implant. you should discuss these and other risks with your surgeon.

8 whaT is shoulder resurfacing?

resurfacing is a procedure where the patient’s humeral head is not removed; it is instead “reamed”

down to fi t a metal “cap” on the top of the bone. This “cap” functions as a humeral head and can be

less invasive than a total joint replacement procedure. your surgeon will determine if you are good

candidate for shoulder resurfacing.

9 whaT abouT The medicaTions i am currenTly Taking?

you should discuss all medications you are currently taking with your surgeon prior to surgery.

your surgeon will advise you if you need to make any adjustments with your medication. certain steroids

can cause a delay in healing after surgery and your surgeon may recommend you not take them. make

sure your surgeon is aware of any steroids you may be taking. generally, your surgeon will also advise

you to stop taking any anti-infl ammatory medications such as aspirin, or ibuprofen fi ve days prior to your

surgery. These medications cause the blood to thin and can lead to excessive bleeding during surgery.

your surgeon will discuss these and all medications you are taking prior to surgery.

16 Shoulder AFTEr SurGErY

1 when will i be able To reTurn To work?

returning to work can be as soon as 2 weeks or as long as 3 months, but your specifi c timetable will

depend on your job and your surgeon’s recommendation. your surgeon will determine when you will

be able to return to work based on your job responsibilities. returning to work will also depend on your

commitment to rehabilitation.

rEcOVErY AFTER SURGERYH I G H L I G H T S F O R P A T I E N T S

as Time passes, you have The poTenTial To eXperience

a dramaTic reducTion in joinT pain and a significanT

improvemenT in your abiliTy To parTicipaTe in daily acTiviTies.

Today, about 4,380 patients

in Australia have shoulder

replacement surgery each year

AOANJRR Australian Orthopaedic Association National Joint Replacement Registry

18

2 whaT will my recovery be like afTer surgery?

Therapy is crucial to proper rehabilitation of your shoulder. your surgeon along with a team of therapists

will work to design a rehabilitation program specifi c to you. Therapy may begin as soon as the day of

surgery and, subject to your surgeon’s recommendation, can last several months post-surgery.

your commitment to following your therapy program will determine how well you recover.

3 will i be able To care for myself afTer surgery?

it is good to have someone help you with daily activities the fi rst few days or weeks after surgery.

you should be able to return to normal activities such as dressing and grooming within a few weeks.

4 when will i be able To shower?

in most cases your surgical incision will be closed with absorbable sutures and covered with surgical

glue or staples. most of the time, you will be able to shower in about 2-3 days after surgery, but you

will not be allowed to submerge your incision in water. a bandage should cover the incision until the 2

week follow-up appointment with your surgeon. your surgeon will advise you of exactly when you will

be able to shower based on the type of closure performed.

5 when will i be able To drive again?

your surgeon will advise you when you will be able to drive again, most likely in 4-6 weeks approximately.

6 how long is The recovery period afTer a shoulder replacemenT?

you will generally be in the hospital for 1-3 days. when you leave the hospital, you will be in a shoulder

Shoulder AFTEr SurGErY

sling and your arm will be sore for several weeks. your surgeon along with the rehabilitation team will work

with you to start your rehabilitation. They will work with you on exercises that you will do at home as well

as in the clinic that will help you recover. Total recovery is patient specifi c, but generally ranges from three

to six months.

7 whaT is The physioTherapy process afTer shoulder replacemenT?

working with a physiotherapist will be critical in your total recovery from shoulder replacement surgery.

your rehabilitation schedule may start as soon as the day of surgery while you are in the hospital.

you will continue to work with a physiotherapy team once you leave the hospital. your surgeon’s offi ce

will set this up for you. you will be given exercises to perform at home, which are designed to increase

your range of motion, mobility and strength. your surgeon will provide you with a list of “do’s and don’ts”

after surgery and your rehabilitation therapy team will work with you to design a specifi c program based

on your individual situation.

20 Shoulder THE iMPLANT

1 whaT is The implanT made of?

There are several different parts that make up a shoulder replacement all being of biocompatible

materials. most humeral heads are made of cobalt chrome, stems are generally made up of titanium to

promote osteogenisis and the glenoid component is generally made up of titanium and/or polyethylene.

THE IMPLANTH I G H L I G H T S F O R P A T I E N T S

There are many Types of differenT shoulder replacemenT

and your surgeon will discuss wiTh you

which one is besT suiTed.

AOANJRR Australian Orthopaedic Association National Joint Replacement Registry

I t is est imated that about 3,309

Australians received a total shoulder

replacement in 2013

22 Shoulder THE iMPLANT

95%is the survivorship of the implant at 10 yearsafter surgery

3rdmost common joint replacement

3.309Australians received a total shoulder replacement in 20134.380

people in Australia have shoulder replacement surgery each year

Talking About Numbers

2 whaT is The survivorship of The ToTal shoulder implanT?

overall, data shows shoulder replacement implants to have average survivorship of 90 to 95% at 10

years after surgery and approximately 80% 20 years after surgery.

3 how common is a shoulder replacemenT?

shoulder replacements are the third most common joint replacement.

new advances in joint replacement have made shoulder replacement a very successful surgery.

it is estimated that about 3.309 australians received a total shoulder replacement in 2013.

4 how many shoulder replacemenTs have been performed?

although shoulder joint replacement is less common than knee or hip replacement, it is just as

successful in relieving joint pain. shoulder replacement surgery was fi rst performed in the united states

in the 1950s to treat severe shoulder fractures.

Today, about 4.380 people in australia have shoulder replacement surgery each year, according to the

australian orthopaedic association national joint replacement registry (aoanjrr).

24 Shoulder YOur NEw JOiNT

most patients with artificial joints are able to enjoy many activities, though some should be avoided.

in general, high impact exercises, such as running, jumping, heavyweight lifting, or contact sports, are

not recommended. participating in these activities, or activities like them, may damage your joint or

cause it to wear down much more quickly. low impact activities such as swimming and walking are

encouraged, subject to your surgeon’s recommendation.

YOur NEW JOINTH I G H L I G H T S F O R P A T I E N T S

in a normal shoulder The humeral head arTiculaTes wiTh

The glenoid (parT of The scapula) in a smooTh manner as

They have a healThy covering of carTilage.

Exercise and maintaining an

active li festyle are important

par ts of heal th

Shoulder NOTES

26

The people appearing in the photographs on this publication

are models and used for illustrative purposes only.

This publication is not intended for distribution in the U.S.

Please remember the information on this document is for educational purposes only

and should not be used to make a decision on a condition or a procedure.

All decisions should be made in conjunction with your surgeon and your primary care provider.

Limacorporate spa

Via Nazionale, 52 - 33038 Villanova di San Daniele - Udine - Italy

Tel.: +39 0432 945511 - Fax: +39 0432 945512

E-mail: info@limacorporate.com

www.limacorporate.com

MKT 01-2015