Revision Shoulder Replacement

A revision shoulder replacement surgery is a procedure to remove the old shoulder replacement and place a new one. A shoulder replacement can fail because of many reasons. In such cases, the doctor replaces the old shoulder replacement with a new one. People are able to perform normal activities and move their shoulders more comfortably after the surgery.

The benefits of revision shoulder replacement surgery are:

1. More comfortable shoulder movement
2. Provides relief from pain
3. Ability to do more everyday activities

Revision shoulder replacement surgery is recommended for patients who have a failed shoulder replacement surgery, feel severe pain, and are finding limitations to using the shoulder muscles.

A failed shoulder replacement can be due to the following reasons:

1. Infection in the artificial joint
2. Artificial replacement coming out of the joint also called dislocation
3. Break/fracture around the shoulder replacement
4. Wearing out of the artificial joint

If the surgery is delayed, it can cause the worsening of the following conditions:

1. The previous implant loosens
2. The infection can worsen
3. Dislocation of the implant
4. Severe pain
5. Inability to use the shoulder

The doctor performs the following steps:

1. Make a cut on the front of the shoulder.
2. Removes the shoulder replacement if it is coming out on its own or the joint surface has become worn.
3. Puts a new shoulder replacement.
4. Cleans and stitchs the cut/wound.

Before the surgery, the doctor will inform you to:

1. Stop taking blood-thinning medicines such as ibuprofen, aspirin, warfarin, naproxen, dabigatran, clopidogrel, apixaban, and rivaroxaban.
2. Consult your doctor who treats their diabetes, heart disease, or other conditions.
3. Stop smoking as it interferes with the healing process

You must tell the following things to the doctor:

1. If you drink too much alcohol 
2. Ask the doctor which medicines can be taken on the day of the procedure
3. If you have a fever, flu, cold, herpes breakout, or other condition.

You can expect the following on the day of surgery:

The doctor will:

1. Ask you to sign the consent form to allow the doctor to proceed with the surgery.
2. Inform you to take medicines with a sip of water.
3. Inform you when to arrive at the hospital.

What to Expect During Revision Shoulder Replacement Surgery?

1. Position during surgery: You will be placed in the beach-chair (also called barbershop) position and lateral decubitus (lying on one side) position.
2. Cleaning and Draping: Proper draping and cleaning will be done to prevent infection and protect your privacy and comfort.

The recovery process in Hospital:

You will:

1. Stay in the hospital for one to three days after the surgery.
2. Get physical therapy to avoid muscle stiffness.
3. Be taught to move the arm by the physical therapist.

The recovery process after hospital discharge:

You:

1. Will be told to keep a sling in the arm to keep the shoulder stress free for around two to six weeks with no active movement.
2. Can resume desk job after two to three weeks and in case of physical, heavier labour work can resume after four or more months.
3. Will be able to do simple activities like dressing up, eating, and grooming in two weeks after the surgery.
4. Might feel pain at night and while doing activities that are common for several weeks.
5. Will be told not to drive for two to six weeks after the surgery.
6. Will be informed not to lift heavy items other than a glass of water for around two to four weeks after the surgery.
7. Will be advised to avoid heavy lifting and any sports activity.
8. Will be told to avoid placing the surgical arm in positions like behind the body or straight out to the side for six weeks after the surgery.

The doctor will inform the patient to visit after two weeks of the surgery to check the recovery. 

Possible side effects that can normally occur after any surgery:

1. Bleeding from the surgical site
2. Pain in the surgical area
3. Allergic reaction to the medicine, materials, or equipment
4. Blood clot in the leg
5. Scarring of the skin
6. Blood clot in the lung
7. Stroke
8. Heart attack

Risk/complications of the surgery:

1. Stiffness in the shoulder
2. Dislocation of the shoulder replacement
3. Rotator-cuff tears (a tear in the tissue connecting bone to muscle) 
4. Loosening of the shoulder replacement
5. Nerve damage around the shoulder
6. Infection at the wound (surgical area) and chest