Life with a shoulder replacement: another 25 patient questions
Can I have an MRI? How can dislocation or implant loosening be recognised? What will the scar look like, and how long will the artificial joint last?
After shoulder replacement, questions may arise beyond the initial recovery of movement. Patients want to know about implant condition, necessary investigations, possible complications and longer-term restrictions.
Below are answers to another 25 questions about shoulder replacements.
Contents
What restrictions may remain after surgery?
What will the surgical scar look like?
Can the joint be replaced after unsuccessful fracture fixation?
Can I have injections into the operated shoulder?
How can I recognise a dislocation?
What does implant instability feel like?
How can implant loosening be recognised?
Can an infection develop around the implant?
Can someone be allergic to implant materials?
What complications may appear years later?
When does the implant need replacing?
How long does the implant last?
Can I have an MRI?
Can I have a CT scan?
Do I need regular X-rays?
How is the implant attached to the bone?
What does the implant look like?
What materials is it made from?
How much does the implant weigh?
What exactly is replaced in a total shoulder replacement?
How long will I need sick leave?
When can I use a steam bath or sauna?
When can I use a swimming pool?
Can I drink alcohol?
Can I return to a full everyday life?
What restrictions may remain after surgery?
Most patients return to independent everyday life. However, regularly lifting heavy objects, forceful overhead movements or contact sports may remain restricted.
Permitted loading depends on implant type, muscle condition and the reason for surgery. Clarify individual restrictions with your surgeon.
What will the surgical scar look like?
The scar is usually on the front of the shoulder. Its length depends on the procedure, body build and implant.
Initially, it may be firm and prominent, then gradually become paler and softer. Redness, drainage or separation of the wound edges require medical advice.
Can the joint be replaced after unsuccessful fracture fixation?
Replacement may be performed after unsuccessful fracture healing, damage to the humeral head or pain around previously implanted metal hardware.
This operation may be more complex than primary replacement. The doctor assesses bone condition, hardware position and muscle function, and excludes infection beforehand.
Can I have injections into the operated shoulder?
Do not have substances injected into an area containing a joint implant without medical assessment. Before any injection, the cause of pain must be established and infection or a mechanical problem excluded.
Steroid medicines, including Diprospan, may be used only on an orthopaedic specialist's decision. An unjustified injection near the implant may create an additional infection risk.
How can I recognise a dislocation?
Dislocation usually causes sudden severe pain, a change in shoulder shape and sharply restricted movement. The arm may rest in an unusual position.
Support and immobilise the arm and seek urgent medical attention. Do not try to put the implant back into place yourself.
What does implant instability feel like?
The patient may feel shifting inside the shoulder, uncertainty during movement or sudden loss of support when trying to raise the arm. Pain may occur in particular arm positions.
Instability cannot be diagnosed from sensations alone. Examination and imaging are needed.
How can implant loosening be recognised?
Possible signs include gradually increasing pain, a decline in previously achieved function and discomfort when loading the arm.
Loosening is confirmed using X-rays and other investigations. New images should be compared with previous ones to assess changes in component position.
Can an infection develop around the implant?
Infection may develop soon after surgery or much later. Rarely, bacteria reach the implant through the bloodstream from another source.
Increasing pain, swelling, redness, wound drainage and fever should raise concern. These symptoms require investigation.
Can someone be allergic to implant materials?
A marked allergic reaction to modern implant materials is rare. Pain or restricted movement is much more commonly related to other causes.
Tell the doctor about any previous reactions to metals. The need for additional investigations is assessed individually.
What complications may appear years later?
Possible late problems include component wear or loosening, instability, damage to surrounding bone and infection.
Most patients do not experience these complications. Nevertheless, new pain or declining function after a stable period should not simply be attributed to ageing.
When does the implant need replacing?
Another operation may be needed for component loosening, recurrent dislocations, deep infection, a fracture near the implant or marked wear.
The decision follows identification of the exact cause of symptoms. Time spent in the body alone is not a sufficient reason to replace the implant.
How long does the implant last?
There is no fixed lifespan. Modern shoulder implants are designed for many years of use, and many remain stable well beyond ten years.
Longevity is affected by age, bone quality, implant design, placement accuracy and the type of loading on the arm.
Can I have an MRI?
In most cases, a modern implant does not prevent MRI. Before the examination, tell the doctor and imaging staff about it.
Metal can interfere with images near the shoulder. Special MRI sequences or another diagnostic method may be used.
Can I have a CT scan?
Yes. An implant does not usually prevent computed tomography. CT may be used to assess component position and surrounding bone.
Metal can create image artefacts, so the imaging specialist should know about the implant beforehand.
Do I need regular X-rays?
Follow-up images allow component position and bone condition to be assessed. Some changes may cause few symptoms for a long time.
The operating surgeon determines the schedule. New pain or instability may mean an X-ray is needed before the planned appointment.
How is the implant attached to the bone?
The humeral component may be fixed using bone cement or press-fitted so that bone gradually grows onto its surface.
Fixation of other elements depends on implant design. The method is chosen according to bone condition and the operation.
What does the implant look like?
The implant replaces damaged joint surfaces rather than the whole arm. It includes components placed in the humerus and the socket region of the shoulder blade.
The shape and number of components depend on the type of replacement chosen.
What materials is it made from?
Components are made from medical-grade metal alloys and durable polyethylene. Some elements may have a special coating to encourage fixation to bone.
Materials are selected for strength, wear resistance and compatibility with the body.
How much does the implant weigh?
There is no single value: weight depends on size, model and the number of components. The patient does not usually perceive it as a separate heavy object.
A feeling of heaviness in the arm more often reflects temporary muscle weakness, swelling or caution during movement.
What exactly is replaced in a total shoulder replacement?
Total replacement places components on the humeral side and at the socket of the shoulder blade. Damaged joint surfaces are replaced with artificial ones.
The arm muscles and most of the patient's bone are preserved. The precise implant design depends on tendon condition and shoulder anatomy.
How long will I need sick leave?
Duration depends on the procedure, arm condition and type of work. Office work may be resumed sooner than physical work or frequent overhead tasks.
The treating doctor decides after assessing whether professional duties can be performed safely.
When can I use a steam bath or sauna?
Heat-based activities should be avoided until the wound has healed completely. High temperatures may increase swelling and affect blood pressure.
Return only with medical permission. Initial visits should be brief and avoid extreme temperatures.
When can I use a swimming pool?
Swimming is possible after complete wound healing and the surgeon's permission. Readiness for different swimming strokes may vary considerably.
Start with gentle movements. Forceful strokes and a large range of movement are appropriate only after sufficient arm control has returned.
Can I drink alcohol?
Alcohol may interact with pain medicines, antibiotics and other prescribed treatments. It also impairs coordination and increases the risk of falling.
Discuss alcohol with your doctor while medication continues.
Can I return to a full everyday life?
Yes. The main aim of replacement is to reduce pain and restore useful arm function. Most patients again manage personal care independently and perform their usual daily activities.
An artificial joint does not always provide the strength and range of movement of a completely healthy shoulder. The result depends on muscles, tendons and the reason for surgery.
A shoulder replacement is designed for long-term use but requires sensible loading and periodic follow-up.
New or increasing pain, a feeling of displacement, a change in shoulder shape, sudden loss of movement or wound drainage are reasons to see an orthopaedic specialist without waiting for the scheduled appointment.
