Revision Shoulder Replacement Info Consent

Why this operation has been suggested

This page reflects how Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, approaches this in our clinic. We usually recommend revision shoulder replacement when your original joint replacement has worn out or loosened. Revisions are typically performed about 3.9 years after the first surgery. You reach our clinic by GP or physiotherapist referral. A clinic assessment establishes the diagnosis. For long-standing problems, we try non-operative care first. We consider surgery when that has not given enough improvement.

We perform this operation as an open approach with a single conventional incision over the operative site. The procedure aims to restore function and reduce pain. Evidence shows an implant survival rate of 85% at ten years. This means the new joint is likely to last for many years. We discuss these outcomes with you to help you decide if this is the right step for your shoulder.

Before the operation

You will need fasting and to stop certain medications before surgery. Your surgeon will give you specific instructions. Please arrange a lift home and bring a list of your current medications. Wear comfortable clothing. You may need X-rays, MRI, blood tests, or an anaesthetic review. These checks help your team plan your care safely. We use an open approach with a single conventional incision over the shoulder. This allows your surgeon to access the joint directly. The procedure is designed to address issues like loosening or wear. Most revisions happen around 3.9 years after the first operation. We aim for a smooth recovery with clear guidance on what to expect next.

On the day

You will arrive at the hospital for admission and meet your anaesthetist. This operation is done under general anaesthetic combined with a regional nerve block. You will be fully asleep for the operation, and the block — an injection that numbs the nerves supplying the arm before you wake up — provides pain relief for the first 12 to 24 hours after surgery. The anaesthetist will meet you before the operation and talk you through both parts.

You will then be taken into the operating theatre. Your surgeon performs this revision as an open approach with a single conventional incision over the operative site. After the procedure, you will wake up in the recovery area. Our team will monitor your comfort and stability as you begin your recovery. Most patients experience very low pain scores after only 2 weeks, though maximum improvement takes one year.

What the operation involves

Your surgeon makes a single cut about 8 to 10 cm long over the front of your shoulder. This open approach gives clear access to the joint. The surgeon removes the worn-out or loose parts of your old implant. This includes the metal and plastic surfaces that have become damaged over time.

If your bone has weakened or lost support, your surgeon may add bone graft. This acts like a scaffold to rebuild strength. The surgeon then fits a new implant into place. For many patients, this is a reverse shoulder replacement. This design uses a ball-and-socket system that works with your remaining muscles to lift your arm. The new parts are fixed securely to your bone.

Once the new joint is in place, your surgeon closes the cut with stitches or staples. A dressing is applied to protect the area. The procedure is tailored to your specific needs. Your surgeon will choose the best components for your anatomy. This ensures the best possible fit and function for your shoulder.

After the operation

You will wake up in the recovery ward. We manage your pain with medication and keep your shoulder supported in a sling. Your wound will be covered with a dressing. Most patients stay one night in hospital after this operation, though some are able to go home the same day. You must have someone stay with you for the first 24 hours. We use an open approach with a single conventional incision over the operative site. You must not drive for at least six weeks after any shoulder operation, regardless of which arm was operated on. Please see Driving after upper-limb surgery for more details.

Recovery

You will have a single incision over your shoulder. In the first few days, pain and swelling are normal. We manage this with medication and rest. Most patients feel a significant drop in pain within two weeks. Your shoulder will feel stiff and heavy. This is part of the healing process.

We guide your rehabilitation through a physiotherapist. Early movement is safe and helps restore function. You will wear a sling to protect the repair. Do not drive while in a sling. Our policy requires no driving for at least six weeks after any shoulder operation, regardless of which arm was treated. You may drive once your surgeon clears you, typically at the six-week review. See our guide on driving after upper-limb surgery for more details.

Daily activities change as you heal. You will focus on gentle exercises to regain motion. You cannot lift heavy objects or reach overhead initially. Sleep may be difficult at first; propping yourself up helps. As swelling settles and movement returns, you will gradually resume normal tasks. Maximum improvement in strength and function takes one year. Your timeline may differ; your surgeon and physio will guide you.

What can go wrong

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

If your shoulder feels loose or unstable, you might notice a clicking or grinding sensation when you move it. This can happen if the components loosen over time. Tell your surgeon at your next review so they can check the fit.

You may feel increasing pain that does not ease with simple painkillers. This could signal that the implant is loosening or that there is wear on the joint surfaces. Contact the clinic to discuss your symptoms.

Watch for signs of infection. Look for redness that spreads out from the wound, warmth, or swelling. You might also have a fever or feel generally unwell. If you notice these signs, call the clinic immediately. Do not wait for your next scheduled appointment.

If you have had a corticosteroid injection recently, be extra vigilant. Injections given within three months before surgery can raise the risk of infection. Report any unusual pain or swelling right away.

Some patients experience stiffness or a loss of movement. You might find it harder to reach behind your back or lift your arm. Mention this to your physiotherapist or surgeon during rehab sessions. They can adjust your exercises to help improve mobility.

Blood clots are a serious risk. You might feel sudden swelling, tenderness, or pain in your calf or thigh. If this happens, go to the emergency department immediately. It is important to rule out a blood clot quickly.

If you have had bariatric surgery in the past two years, your risk of complications is higher. Be honest with your surgeon about your medical history. This helps them plan your care and monitor you more closely.

The complications table on this page lists typical rates if you want the specifics.

When to call us

Call us or go to emergency if you have a fever, increasing wound redness or discharge, or sudden severe pain. Seek urgent care for calf swelling, shortness of breath, loss of sensation, or inability to move your limb. These symptoms need immediate assessment by your surgeon.