A Complete Guide to Shoulder Surgery
Types of shoulder surgery procedures include:
Arthroscopy is surgery using an arthroscope. An arthroscope is a long, thin instrument that contains a small camera. It is inserted into the joint through an incision over or near the joint. The camera transmits pictures of the inside of your joint to a video screen that your surgeon views while performing surgery.
Your doctor may recommend arthroscopic shoulder surgery for:
- shoulder dislocations
- shoulder tendonitis
- certain rotator cuff problems
- muscle repairs
- frozen shoulder
- repair of torn cartilage or ligaments
Arthroplasty replaces or resurfaces a diseased joint. It involves removing arthritic or damaged surfaces of bone and replacing them with artificial material or an implant called a prosthesis. Arthroplasty can include a partial replacement or a total replacement of your shoulder joint.
Your doctor may recommend shoulder arthroplasty for degenerative diseases of the shoulder, such as osteoarthritis and rheumatoid arthritis. Some fractures of the shoulder joint may also require joint replacement.
Rotator cuff repair
A rotator cuff repair reattaches a torn rotator cuff. This treatment is for a torn tendon in the shoulder joint. Sometimes, a partial tear may only require a procedure where the surgeon trims or smooths the tendon. A full tear will need the tendon reattached onto the bone.
Doctors may recommend this treatment if your pain has not improved with nonsurgical methods.
Your doctor may perform other procedures in addition to shoulder surgery. These include:
- Bone fracture or dislocation repair: Severe injuries may require surgical repair. These injuries include certain types of fractures of the clavicle (collarbone) and humerus (upper arm bone), and shoulder dislocations.
- Bursectomy or bursa sac repair: This procedure is one option to treat a damaged bursa sac. Your bursa sac provides cushioning for your joint.
Your doctor may recommend shoulder surgery to treat a damaged, degenerated, or diseased shoulder joint.
Aging, disease, overuse, or injury can damage your shoulder joint. Your doctor may only consider shoulder surgery for you if more conservative treatments have not worked. Ask your doctor about all treatment options and consider getting a second opinion before deciding on shoulder surgery.
Your doctor may recommend shoulder surgery to treat:
- arthritis, shoulder inflammation as a result of either osteoarthritis or rheumatoid arthritis
- bursitis, inflammation of your bursa sac
- cartilage conditions, such as loose or torn cartilage
- fracture of the collarbone or upper arm bone
- frozen shoulder, also known as adhesive capsulitis, which is stiffness of the shoulder joint
- rotator cuff tears, both partial and complete tears
- shoulder dislocation that reoccurs often
- shoulder separation, a partial or complete tear of shoulder ligaments
- tendonitis, inflammation of your tendon that is not responding to more conservative treatment
Your shoulder surgery will take place in a hospital or outpatient surgical setting. The procedure and technique vary depending on the specific surgery, but it generally involves one of the following:
Minimally invasive surgery
Also known as arthroscopy, minimally invasive surgery involves inserting special instruments and an arthroscope through small incisions in your shoulder.
This type of surgery causes the least damage to tissues and organs. The surgeon moves around muscles and tissues instead of cutting through or displacing them.
Minimally invasive surgery generally offers faster recovery, less pain, and less risk of complications than other types of surgery.
This technique uses newer technology and combines minimally invasive arthroscopic techniques with a smaller open procedure. The incision is smaller than a standard open surgery incision, but the surgeon can still directly see the tissue.
This technique allows more extensive repairs than are possible with minimally invasive surgery. It also causes less damage than traditional open surgery because your muscles remain attached during surgery.
Open surgery involves making a large incision in the shoulder. This allows your surgeon to directly view and access the surgical area. More cutting and displacement of muscle and tissues are necessary than with minimally invasive surgery.
Open surgery generally involves a longer recovery and more pain than minimally invasive surgery.
Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital. These decisions are based on your diagnosis, age, medical history, general health, and possibly your personal preference.
You may want to learn about the different procedures and ask your surgeon why they will use a particular one for you.
On the day of your surgery, you can generally expect to:
- Talk with a preoperative nurse: The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
- Remove all clothing and jewelry, and dress in a hospital gown: It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
- Talk with the anesthesiologist or nurse anesthetist: You will discuss your medical history and the type of anesthesia you will receive.
- Receive an IV line: A surgical team member will start an IV line, which administers anesthetic through a vein.
- Receive an anesthetic: The anesthesiologist or nurse anesthetist will start your anesthesia. They will then place a tube in your windpipe to protect and control your breathing. You will not feel or remember this or the surgery.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout both the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
As with all surgeries, shoulder surgery involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
- anesthesia reaction, such as an allergic reaction and problems with breathing
- blood clot, such as a deep vein thrombosis
Potential complications of shoulder surgery
- blood vessel, nerve, or muscle damage
- deltoid detachment, a complication of open surgery on the rotator cuff
- failure of the repair to heal or to relieve symptoms
- nerve damage, which can lead to numbness and tingling in the affected arm
- problems with a newly replaced joint, such as wear and tear of a new joint requiring another replacement
- stiffness and loss of range of motion, which is usually temporary and responds well to aggressive physical therapy
- tendon re-tear, which is more common with larger tendon tears
- weakness in your shoulder
Facing surgery can be stressful. It is common for patients to forget some of their questions during a brief doctor’s office visit. You may also think of other questions after your appointment.
Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to take a list of questions to your appointments.
Questions can include:
- Why do I need shoulder surgery? Are there other options for treating my condition?
- Which type of shoulder surgery procedure will I need?
- How long will the surgery take? When can I go home?
- What restrictions will I have after the surgery? When can I return to work and other activities?
- What kind of assistance will I need at home?
- What kind of physical therapy or rehabilitation will I need?
- What medications will I need before and after the surgery? How do I take my usual medications?
- How will you treat my pain?
- When should I follow up with you?
- How should I contact you, both during and after regular hours?
Knowing what to expect can make your road to recovery as smooth as possible.
After shoulder surgery, your healthcare team will cover the incisions with a dressing. They will move you from the operation room into a recovery room.
You may experience some pain at this point and require some pain medication, but some people feel no pain at all.
Your healthcare team will then give you instructions on postoperative care before discharging you to go home.
You may experience pain for several weeks after returning home from surgery. This is normal, but you can request pain medications from your doctor if needed. You can also use ice to relieve pain in your shoulder.
Some people find sleeping on their back uncomfortable after shoulder surgery. Sleeping on a reclining chair or propping yourself up with cushions may ease this discomfort.
Your healthcare team will give you specific instructions on how to care for wounds at home. You may be able to change your dressings a couple of days after surgery. You can usually shower once your wounds have stopped draining, but try to avoid soaking or scrubbing them.
The healthcare team may also give you a sling to wear for a few weeks after surgery.
It can take several weeks to fully recover from shoulder surgery and regain full movement. Your doctor will refer you to a physical therapist. Your therapist will work with you to put together a plan to rehabilitate your shoulder after surgery.
Common types of shoulder surgery include arthroscopy, arthroplasty, and rotator cuff repair. These surgeries can treat a variety of shoulder injuries and conditions.
Shoulder surgery may resolve your condition or reduce your symptoms so you can lead an active, normal life. For example, shoulder surgery may relieve your pain and restore strength and good range of motion to your shoulder. Shoulder surgery will not prevent future damage to your shoulder.