Total Shoulder Arthroplasty Info Consent
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
Why this operation has been suggested
Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes the diagnosis. For long-standing wear-and-tear arthritis, we usually try non-operative care first. We consider surgery when that has not given enough improvement.
Shoulder replacement is a joint replacement procedure. It is typically offered to patients with severe arthritis or complex instability who have not found relief otherwise. We recommend this operation to restore function and reduce pain. Evidence shows that 96% of implants survive at 2 years. This high survival rate supports our recommendation for a shared decision on your care.
Before the operation
We ask you to fast for seven hours before your surgery. This allows your list to start early if needed. Please arrange a lift home and wear comfortable clothing. Bring a list of all current medications. Your surgeon will advise which medicines to stop. Imaging such as X-rays, MRI, or ultrasound helps plan your operation. Most patients do not need blood tests or an anaesthetic review. If you have other medical conditions, you may need these checks. We ensure your preparation is simple and safe for your specific needs.
On the day
You present to the hospital's surgical admissions unit, where you are checked in and prepared for theatre. 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 are then taken into the operating theatre, where the operation is performed. You wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. Once you are stable you either go to the ward or go home, depending on the procedure and your recovery.
What the operation involves
Your surgeon makes a single cut over the shoulder area to access the joint. This open approach allows clear visibility of the structures inside. The surgeon removes the worn-out joint surfaces and prepares the bone. A key part of this step is ensuring the new socket component is positioned correctly. This precise placement is essential for the long-term function of your shoulder.
The surgeon then fits the new components into place. These parts are made of metal and plastic surfaces designed to mimic your natural joint movement. If you are having a reverse shoulder replacement, the components are arranged differently to work with your remaining muscle strength. Your surgeon follows strict techniques to ensure the parts are secure. For some patients, this may involve reattaching torn tendons or repairing bone fragments using small anchors to hold them in place.
Once the new joint is in position, your surgeon closes the skin. A fine self-adhesive mesh is laid over the closed wound first, holding the skin edges together. A liquid skin adhesive is then painted over the mesh, where it sets to seal the whole thing. This mesh and adhesive form one closure. It stays on for roughly one to two weeks and then lifts and peels away by itself, so there is nothing to be taken out.
After the operation
You will wake up in a recovery ward with your arm in a simple sling for comfort. We manage pain using general methods so you stay comfortable. A sterile dressing covers the single cut made over the area being operated on. Someone should stay with you for the first 24 hours to help you. Most patients stay one night in hospital after this operation, though some are able to go home the same day. 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 details. Your sling comes off for exercises and washing as we guide you.
Recovery
You will feel soreness and swelling in the first few days. This is normal. Your surgeon will prescribe pain relief to help you rest. Resting with your arm supported in a simple sling helps reduce discomfort. The sling is for comfort only. You will remove it for your exercises and washing.
Your physiotherapist will guide your rehabilitation. You will start gentle movements soon after surgery. Early activity is safe and helps restore motion. You will do specific exercises to strengthen the muscles around your shoulder. These movements may feel challenging at first. As your strength returns, you will progress to more demanding tasks. Most patients regain fundamental strength and range of motion over time.
Daily life changes as you heal. You will need help with tasks that require both hands. Sleep may be difficult at first. Try propping yourself up with pillows. You cannot drive while in a sling. Your surgeon will clear you to drive, typically at the six-week review. See our guide on Driving after upper-limb surgery for details.
Return to work and sport depends on your job and activity level. Patients with less demanding jobs often return sooner. High-demand sports may take longer. Many patients successfully return to recreational activities. Your timeline may differ. Your surgeon and physio will guide you based on your progress.
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 you have an infection, you might notice increasing redness, warmth, or swelling around the shoulder. The area may feel tender or painful. You might also develop a fever or chills. Contact your clinic immediately if you see these signs. Early treatment helps protect your joint.
Dislocation means the ball of the shoulder slips out of the socket. You may feel a sudden pop, sharp pain, or a clicking sensation. Your arm might feel weak or unable to move normally. If this happens, go to the emergency department or call your surgeon right away. Do not try to force it back in place yourself.
A fracture is a break in the bone near the implant. You might feel a deep, sharp pain that does not ease with rest or simple painkillers. There may be visible swelling or bruising. Seek urgent medical care if you suspect a break.
Blood clots are uncommon but serious. Watch for sudden swelling, pain, or redness in your calf or thigh. If you experience shortness of breath or chest pain, call emergency services immediately. These could be signs of a clot moving to your lungs.
Implant loosening can cause a grinding feeling or new pain when you move your shoulder. The pain might start gradually or come on suddenly. Tell your surgeon if you notice changes in how your shoulder feels during daily activities.
Some patients experience persistent stiffness or limited movement. If you cannot lift your arm as expected during recovery, mention it at your next review. Your team can adjust your therapy to help improve mobility.
Rarely, patients may develop a pseudoaneurysm, which is a bulge in a blood vessel. You might feel a pulsing mass or notice unusual swelling. Report any new lumps or pulsating sensations to your doctor promptly.
The complications table on this page lists typical rates if you want the specifics.
When to call us
Call us if you develop a fever, increasing wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling, shortness of breath, loss of sensation, or inability to move your limb. We want to catch any complications early. Your surgeon is here to help you recover safely.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Shoulder Arthritis page.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Shoulder Arthritis page.
