Shoulder replacement surgery, also known as shoulder arthroplasty, is a procedure that involves removing damaged parts of the shoulder joint and replacing them with prosthetic components. This surgery is commonly recommended for patients suffering from severe arthritis, rotator cuff problems, or shoulder fractures that cannot be repaired with other surgical methods. It is typically considered when conservative treatments such as physiotherapy, injections, or medications fail to provide relief.

In this detailed guide, we will walk you through the shoulder replacement procedure, the recovery process, post-surgical rehabilitation, and how Palms Physiotherapy & Allied Health can support you both before and after the surgery.

Shoulder Replacement Surgery: Procedure, Recovery, and Rehabilitation

What is Shoulder Replacement Surgery?

Shoulder replacement involves replacing the damaged parts of the shoulder joint with artificial components made of metal, plastic, or ceramic. There are two main types of shoulder replacement:

• Total Shoulder Replacement (Anatomical): Both the ball (humeral head) and the socket (glenoid) of the shoulder joint are replaced with prosthetics.

• Reverse Shoulder Replacement: In this procedure, the positions of the ball and socket are reversed. The ball is placed on the shoulder blade, and the socket is attached to the upper arm bone. This is typically used in cases where the rotator cuff is severely damaged or non-functional.

Shoulder replacement is commonly performed for the following conditions:

• Osteoarthritis.

• Rheumatoid arthritis.

• Severe fractures.

• Rotator cuff arthropathy (degeneration of the rotator cuff muscle).

The Shoulder Replacement Surgery Procedure

1. Pre-Surgical Preparation

• Diagnostic Evaluation: Prior to surgery, diagnostic tests such as X-rays or MRI scans are used to assess the extent of damage to the shoulder joint and plan the appropriate surgical approach.

• Pre-Operative Physiotherapy (Pre-Hab): Strengthening exercises and mobility training may be recommended before surgery to help improve joint function and shorten recovery time.

2. Surgical Procedure

• Incision: A surgical incision is made over the shoulder, and the damaged parts of the shoulder joint are removed.

• Prosthetic Insertion: The prosthetic components are then inserted into the shoulder, including the humeral stem (which goes into the upper arm bone) and the glenoid (which is attached to the shoulder blade).

• Duration: Shoulder replacement surgery typically takes 2 to 3 hours, depending on the complexity of the procedure.

3. Post-Surgical Care

• Pain Management: Post-operative pain is common but can be managed with medications and ice to reduce swelling. You may also receive a nerve block or regional anesthesia to reduce pain immediately following the surgery.

• Hospital Stay: Most patients stay in the hospital for 2 to 3 days after the procedure, although some may be discharged on the same day depending on their recovery.

Recovery Timeline After Shoulder Replacement Surgery

Immediate Post-Operative Phase (Days 1–7)

• Hospital Recovery: During your stay in the hospital, you will be monitored for any signs of complications and begin gentle exercises to maintain joint mobility.

• Pain Control: Ice packs, medications, and possible nerve blocks will help manage pain.

• Sling Usage: A sling is typically worn for the first few weeks to protect the shoulder and support the healing process.

Short-Term Recovery (Weeks 1–6)

• Sling Use: You will likely need to wear a sling for 3–4 weeks to protect the joint and allow initial healing.

• Follow-Up Appointments: Your surgeon will monitor your progress and adjust your rehabilitation plan. X-rays may be taken to ensure the prosthetic components are in place and healing properly.

• Initial Rehabilitation: Gentle range of motion exercises will be introduced to prevent stiffness and improve shoulder movement.

Long-Term Recovery (Months 1–6)

• Rehabilitation: During the first 3 months, you will gradually begin strengthening exercises to rebuild muscle strength and joint function.

• Full Recovery: While the initial healing phase takes about 3–6 months, complete functional recovery may take up to a year or more, especially for those undergoing reverse shoulder replacement.

Rehabilitation After Shoulder Replacement Surgery

Phase 1: Early Rehabilitation (Weeks 1–6)

• Focus: Protect the surgical site, reduce pain and swelling, and start gentle motion.

• Exercises:

  • Pendulum exercises: Gentle movements to keep the shoulder from becoming stiff.

  • Passive range of motion (PROM): Assisted shoulder movements to prevent immobilization.

  • Ice therapy: To manage swelling and discomfort.

Phase 2: Active Rehabilitation (Weeks 6–12)

• Focus: Begin restoring mobility and start strengthening.

• Exercises:

  • Active range of motion (AROM): You will gradually perform movements without assistance.

  • Strengthening: Isometric exercises to activate the shoulder muscles without causing strain on the joint.

  • Stretching: To improve flexibility and reduce tightness.

Phase 3: Strengthening and Functional Training (Months 3–12)

• Focus: Restore full function and regain strength.

• Exercises:

  • Progressive strengthening: Resistance band exercises and light weight training to strengthen the muscles around the shoulder.

  • Functional exercises: Relearning tasks that require the shoulder joint, such as reaching, lifting, and rotating.

  • Sport/Activity-Specific Rehab: For patients wishing to return to sports or physical labor, rehabilitation programs focus on building endurance and agility.

How Palms Physiotherapy & Allied Health Can Help

Pre-Habilitation Services

• Strengthening the Shoulder: Pre-surgical physiotherapy helps improve strength and flexibility, leading to faster recovery after surgery.

• Education: We educate patients on what to expect during the recovery process, including sling usage, pain management, and initial rehabilitation exercises.

• Joint Mobility: Pre-hab exercises help maintain joint flexibility and reduce the risk of stiffness post-surgery.

Post-Operative Rehabilitation

• Individualized Rehab Program: After surgery, our physiotherapists design a personalized rehabilitation plan tailored to your needs and recovery goals.

• Pain and Swelling Management: Techniques like manual therapy, ice therapy, and ultrasound are used to reduce swelling and manage pain.

• Strengthening Exercises: As you recover, we provide gradual strengthening exercises to restore muscle function, stability, and range of motion.

• Functional Training: We focus on helping you regain normal activities, whether that’s returning to work, sports, or daily tasks.

• Sport-Specific Rehabilitation: For athletes or individuals with physical job demands, we help them safely return to their pre-surgery level of performance.

Frequently Asked Questions

1. How long will it take to recover from shoulder replacement surgery?

Full recovery typically takes 6–12 months, with significant improvement in function occurring within the first 3–6 months. Some patients may take up to a year to fully regain strength and mobility.

2. Will I regain full shoulder function after surgery?

Most patients experience significant improvement in pain relief, mobility, and function. Full recovery depends on factors such as the severity of the original condition, adherence to rehabilitation, and the type of shoulder replacement.

3. How soon can I return to work after shoulder replacement surgery?

For sedentary jobs, patients can return to work within 4–6 weeks. For more physically demanding jobs, a return to full duties may take 12–16 weeks, depending on recovery progress.

4. Do I need to wear a sling after shoulder replacement surgery?

Yes, you will likely need to wear a sling for 3–4 weeks to protect the shoulder during the healing process.

5. What are the risks of shoulder replacement surgery?

As with any surgery, there are risks of infection, blood clots, nerve damage, and prosthetic failure. However, these risks are relatively low, and your surgeon will take precautions to minimize them.

Reputable Australian Resources

• Health Direct – Shoulder Surgery: https://www.healthdirect.gov.au/shoulder-surgery

• Better Health Channel – Shoulder Replacement Surgery: https://www.betterhealth.vic.gov.au/shoulder-replacement

• Australian Physiotherapy Association: https://australian.physio