Every patient’s situation is different, depending on factors such as age, health status, and the reason for having shoulder surgery.
But, in general, both traditional and reverse shoulder replacements are performed in the hospital and usually take less than two hours. Shoulder surgery usually requires general anesthesia. Patients often go home the same day or stay overnight in the hospital.
The first step—in advance of the surgery—is often 3D surgical planning, which involves CT scan imaging of the affected shoulder. Then, the results are analyzed by specialized digital software to create a 3D representation of the patient’s shoulder anatomy. “That allows us to simulate the placement of the implant and determine the bone preparation and every aspect of the instrumentation before entering the operating room,” Dr. Donohue says.
Shoulder replacement surgery is not minimally invasive, but both traditional and reverse shoulder replacements are muscle-sparing, meaning they cut through less muscle tissue than traditional surgery, which can mean a quicker recovery and improved outcome. Patients may be positioned sitting upright or semi-upright to allow better access to the shoulder. The surgeon makes an incision that’s often a few inches long—although the size varies, depending on the patient—on the front of the shoulder, then navigates the surgical instruments between the muscles to the joint, minimizing the need to cut tissue.
In addition to general anesthesia, a nerve block—an anesthetic used only on the surgical site—helps relieve surgical pain and reduces or eliminates the need for opioid medication after surgery. The nerve block is already working when the patient wakes up from the surgery, at which point pain may be managed with oral medications, a cold therapy machine (special equipment that uses cold to numb the area), and compression sleeves. “Nerve blocks allow us to use less general anesthesia, and they are extremely helpful in reducing the amount of initial—and overall—pain,” Dr. Donohue says.