Permanent Restrictions After Shoulder Replacement: What to Expect
Permanent restrictions after shoulder surgery are important considerations following shoulder replacement, whether traditional or reverse. Shoulder replacement is a pivotal procedure aimed at alleviating chronic pain and restoring function to a damaged shoulder joint. While it offers significant improvement in quality of life, permanent restrictions after shoulder surgery are necessary to ensure proper healing and preserve the durability of the new joint. This systematic review will cover the postoperative limitations of reverse shoulder replacement surgery, typical recovery timelines, reasons for undergoing shoulder replacement, and the unavoidable permanent restrictions that come with this procedure.
Permanent Restrictions After Shoulder Surgery: What is Shoulder Replacement Surgery?
Shoulder replacement surgery comprises the insertion of a substitute joint instead of the injured shoulder joint. There are two primary types of shoulder replacement surgeries:-
Total Shoulder Replacement (TSR): By this technique, both the ball (humeral head) and the socket (glenoid) of the shoulder joint are replaced.
Reverse Shoulder Replacement (RSR): Different from TSR, in reverse shoulder replacement there are swapped ball and socket positions. This kind of surgery is very useful for rotator cuff disorders or glenohumeral disorders in the shoulder joint.
In both scenarios, the aim of the operation is not only pain relief and shoulder function, but also life quality for the patient.
What Are the Limitations After Reverse Shoulder Replacement?
Following reverse shoulder replacement surgery, patients are, for the most part, limited in their activity level for an extended period in order to enable healing of the newly implanted shoulder joint. These restrictions play a critical role in the outcome of the procedure and survival of the implant. Below, we’ve broken down the most common permanent restrictions that patients may face:-
Limited Range of Motion (ROM)
One of the most common limitations after reverse shoulder replacement surgery is a limited range of motion, especially when it comes to overhead movements. The range of motion of the arm above the shoulder or that of the shoulder joint at the back of the head may be limited in the early postoperative period. With physical therapy, the range of motion may be improved over time, though it is likely that full motion will never have the degree of natural shoulder joint.
Avoiding Heavy Lifting
After reversing shoulder replacement, lifting heavy objects is limited to avoid stress on the joint and prevent dislocation or wear, especially during early recovery.
No High-Impact Sports or Activities
Some, such high-impact sports such as football, basketball, and rugby, may not be appropriate for post-shoulder replacement patients. These activities can put stress on the new joint, increasing the risk of complications like dislocation or damage to the implant. Furthermore, physical activities demanding high shoulder movements such as swimming or tennis may also be limited.
Permanent Restrictions After Shoulder Surgery: Rotator Cuff Functionality
After a reverse shoulder replacement, the rotator cuff muscles may not function as effectively as before. Since the mechanics of the shoulder joint are changed, the body adapts to these changes. Although this treatment can at least for the strengthening of the surrounding muscles, there are still residual limitations in the function of the rotator cuff. For individuals with existing rotator cuff injuries prior to surgery, the recovery process may be more complex.
Reverse Shoulder Replacement Surgery: Recovery Time and Considerations
Assessment of reverse shoulder replacement surgery recovery time is a crucial factor in setting accurate expectations and preparing for post-operative treatment. The recovery process from case to case, but generally, consists of the stages described below:-
Initial Recovery Phase (0-6 Weeks)
In the initial period of up to 6 weeks after reverse shoulder replacement surgery, patients need to be in a sling to immobilize the shoulder to prevent dislocation). In this period, it is of vital importance to enable the incision to close and to reduce swelling. Pain relief is generally a focus of the initial recovery phase and your doctor will prescribe medications for pain relief.
Physical Therapy and Rehabilitation
Physical therapy starts shortly after surgery, and passive exercises are in the early stages where the therapist moves the arm for the patient. Activity exercise starts when fitness and mobility increase. In the meantime, the patients will be practicing gentle stretching, movement training, and finally muscle strengthening.
Therapy Goals: –
- Reduce pain and swelling
- Restore the shoulder’s range of motion
- Strengthen surrounding muscles
- Prevent stiffness and rigidity
Long-Term Recovery (6-12 Months)
The long-term recovery period is also time-consuming and individual-dependent. Generally, it can take anywhere from six months to a full year to regain significant strength and functionality in the shoulder joint. Complete recovery will rely upon the use of physical therapy guidelines, and the compliance of the patient with their post-operative treatment instructions.
Is Shoulder Replacement Surgery Worth It?
When considering shoulder replacement, weigh the benefits of pain relief and improved function against potential risks. Most patients report an enhanced quality of life.
Benefits of Shoulder Replacement Surgery: Benefits of Shoulder Replacement Surgery:-
Pain Relief: The greatest advantage is the reduction or disappearance of chronic shoulder pain due to arthralgia or injury.
Restored Function: It helps reduce risks, shorten healing time, and ensure the best results.”
Improved Quality of Life: By reducing pain and improving mobility, many patients report a better overall quality of life, with the ability to engage in daily tasks without discomfort.
Risks and Complications: –
Like, any surgery, there are inherent risks that accompany shoulder replacement surgeries). These include:-
Infection: Infection risk is always a concern with any surgery.
Implant Failure: Implants, though relatively rare, may become worn down or fail in time.
Blood Clots: Patients need to be aware and take measures against blood clots, which can occur after any surgical procedure.
Nerve Damage: In certain instances, nerve injury may take place, resulting in numbness or weakness of the arm.
Shoulder replacement has a high success rate, offering long-term pain relief and functional improvement for most patients.
Permanent Restrictions After Shoulder Replacement Surgery
After reverse shoulder replacement, many patients will experience permanent restrictions that help preserve the functionality of the shoulder joint and minimize wear on the implant. These restrictions typically include:-
Avoiding Overhead Activities: Such activities involve, e.g., reaching above the head, moving above the horizontal plane of the shoulder joint, or performing plyometric exercises.
Limiting Certain Sports: Competitive activity and contact sports in general and heavy lifting after surgery are generally contraindicated.
Preventing High-Pressure Movements: They will limit some physical activities that apply excessive strain on the shoulder, e.g., pushing heavy weights or carrying heavy masses.
Following post-operative care recommendations helps patients achieve the best long-term outcomes from surgery.
Post-Operative Care for Shoulder Replacement Surgery
Proper post-operative care is essential to ensure that the reverse shoulder replacement surgery is successful.
It helps reduce risks, shorten healing time, and ensure the best results.
Permanent Restrictions After Shoulder Surgery: Physical Therapy and Rehabilitation
Rehabilitation is a critical component of recovery. Patients need to attend therapeutic sessions on a regular basis in order to regain strength, flexibility, and range of motion. Your therapist will lead you through exercises to restore your control over the shoulder joint.
Follow-Up Appointments
Routine monitoring and follow-up appointments are essential to assess humeral head movement, and joint healing, and detect potential complications like implant dislocation or wear.
Alternatives to Shoulder Replacement Surgery
For patients who are unlikely to be sufficient candidates for surgery due to the condition of the glenohumeral joint, or for patients who choose an alternative to surgery, covered methods exist:-
Physical Therapy: The primary treatment for shoulder pain involves exercises to strengthen shoulder muscles.
Steroid Injections: Corticosteroids can be used to control inflammation and pain for a multitude of months.
Shoulder Arthroscopy: This minimally invasive procedure can treat some shoulder issues without full replacement surgery.
Conclusion
Reverse shoulder replacement surgery is an effective treatment for disabling shoulder pain due to arthritis or trauma. While it improves pain relief and function, it’s essential to consider the postoperative limitations and provide careful recovery care. By following your healthcare provider’s recommendations and undergoing proper rehabilitation, patients can enjoy long-lasting benefits and enhanced quality of life. Never use advice from your doctor to see if shoulder replacement surgery is necessary for you.
