Our Summary

This research paper is about the outcomes of shoulder replacement surgeries, specifically those that need to be redone, or “revisions.” Shoulder replacements are becoming more common, and so are revision surgeries. The paper aimed to understand the expected improvement in shoulder function and how long the new implant lasts after a revision surgery.

To do this, the researchers looked at a bunch of studies that reported on how well patients’ shoulders functioned after their surgery and how long the implants lasted. They looked at 15 studies involving 593 revision surgeries.

The results varied greatly. Some people had a lot of improvements in their shoulder function after surgery, while others didn’t. The implants from the revision surgeries lasted at least 5 years for over 80% of patients, and at least 10 years for over 70% of patients.

Importantly, the type of original implant did not impact the outcomes of the revision surgery. So, the idea that revising a certain type of shoulder replacement (a hemiarthroplasty) might lead to better outcomes compared to revising a total shoulder replacement isn’t supported by the current research.

FAQs

  1. What was the aim of the research paper about shoulder replacement surgeries?
  2. What were the findings regarding the longevity of implants after revision surgeries?
  3. Does the type of original implant affect the outcomes of shoulder revision surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about shoulder replacement is to follow their rehabilitation program diligently. Physical therapy and exercises are crucial for a successful recovery and regaining full function of the shoulder. It’s important for patients to be patient with the recovery process and not rush into activities that could potentially damage the new implant. By following the rehabilitation program as prescribed by their healthcare provider, patients can optimize their shoulder function and overall outcomes after surgery.

Suitable For

Patients who are typically recommended for shoulder replacement surgery are those who have severe shoulder pain and stiffness that does not improve with conservative treatments such as physical therapy, medications, and injections. Common conditions that may warrant a shoulder replacement include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, and rotator cuff tears.

Patients who have failed previous shoulder surgeries, such as rotator cuff repair or shoulder stabilization procedures, may also be candidates for shoulder replacement. Additionally, patients who have significant functional limitations and decreased quality of life due to their shoulder condition may benefit from shoulder replacement surgery.

Overall, the decision to recommend shoulder replacement surgery is made on a case-by-case basis, taking into consideration the patient’s overall health, level of pain and disability, and expectations for surgery. It is important for patients to discuss their options with their orthopedic surgeon to determine if shoulder replacement is the best course of action for them.

Timeline

Before shoulder replacement:

  • Patient experiences chronic shoulder pain, stiffness, weakness, and limited range of motion
  • Patient undergoes a series of conservative treatments such as physical therapy, medications, injections, and lifestyle modifications
  • If conservative treatments fail to provide relief, patient and their healthcare provider decide to proceed with shoulder replacement surgery

After shoulder replacement:

  • Patient undergoes pre-operative evaluations and tests to assess their health and fitness for surgery
  • Patient undergoes shoulder replacement surgery, which involves replacing damaged parts of the shoulder joint with artificial components
  • Patient goes through post-operative care, including pain management, physical therapy, and follow-up appointments
  • Patient gradually regains shoulder function, strength, and range of motion over weeks to months
  • Patient may experience some initial discomfort and limitations in movement, but these improve with time and rehabilitation
  • Patient enjoys improved shoulder function, reduced pain, and increased quality of life after successful shoulder replacement

What to Ask Your Doctor

Some questions a patient should ask their doctor about shoulder replacement include:

  1. What are the potential risks and complications associated with shoulder replacement surgery?
  2. What is the expected recovery time and rehabilitation process after surgery?
  3. How long can I expect the shoulder replacement implant to last before needing a revision surgery?
  4. What are the success rates for revision surgeries, and what factors may impact the outcome?
  5. What is the expected improvement in shoulder function after surgery, and how long does it typically take to see these improvements?
  6. Are there any alternative treatments or therapies that I should consider before opting for shoulder replacement surgery?
  7. How experienced are you in performing shoulder replacement surgeries, and how many have you done successfully?
  8. What type of implant will be used for my shoulder replacement, and how does it compare to other options available?
  9. What can I do to optimize the success of my surgery and improve the long-term outcomes of my shoulder replacement?
  10. Are there any lifestyle changes or modifications I should make before or after surgery to ensure the best results?

Reference

Authors: Davies A, Selmi H, Sabharwal S, Vella-Baldacchino M, Liddle AD, Reilly P. Journal: J Shoulder Elb Arthroplast. 2022 Apr 26;6:24715492221095991. doi: 10.1177/24715492221095991. eCollection 2022. PMID: 35692902