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The Joint Replacement Center at
Johnson City Medical Center
Shoulder Replacement
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 What is arthritis and why does my shoulder hurt?
In the shoulder joint there is a layer of smooth cartilage on the shoulder socket and ball. This cartilage serves as a cushion and allows for smooth motion of the shoulder. Arthritis is a wearing away of this smooth cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.
What is a total shoulder replacement?
A total shoulder replacement is really a cartilage replacement with an artificial surface. The shoulder itself is not replaced, as is commonly thought, but rather an artificial substitute for the cartilage is inserted on the end of the bones. This is done with a metal alloy on the ball and plastic spacer on the socket. This creates a new smooth cushion and a functioning joint that does not hurt.
What is a Reverse Shoulder?
A reverse shoulder is for people who do not have a repairable rotator cuff and have exhausted all other means of repair of their degenerated shoulder. At this stage of shoulder instability and pain, it is necessary to make changes in the mechanics of the shoulder. In the healthy shoulder, the upper arm bone (humerus) ends in a ball shape. This fits into a socket formed by the shoulder blade (scapula). Together this ball and socket form the shoulder joint. The Reverse Shoulder, reverses the anatomy, or structure, of the healthy shoulder.
The implant is designed so that the ball portion is attached to the shoulder blade and the socket is placed at the upper end of the upper arm bone. This new configuration allows the deltoid muscle, which is one of the larger and stronger shoulder muscles, to raise the arm.
Exercising Before Surgery
It is important to be as fit as possible before undergoing a total shoulder replacement. This will make your recovery much faster. Exercises are shown in your Patient Guidebook that you can follow. Consider a minimum of 15-20 minutes twice a day prior to your surgery. Please document exercise in your clinical diary section of your Patient Guidebook.
Stop any exercise that is too painful
You have the right to make decisions about your medical care. You have to be informed of treatment and consent to be treated. You can refuse or have taken away any medical treatment, with very limited exceptions. If you have advance directives, please bring copies to the hospital on the day of surgery.
READ "Basics of Anesthesia" (Appendix in your notebook)
Total Joint Surgery does require the use of either general anesthesia or regional anesthesia. Please review "Basics of Anesthesia" (see appendix in your Patient Guidebook) provided by our anesthesia department. You will discuss this with the anesthesiologist on the morning of your surgery.
Donating Your Blood
If you wish to donate your own blood your surgeon's office will make arrangements for you.
Pre-Operative Visit To Surgeon
You should have an appointment in your surgeon's office the week before your surgery. (Refer to first page of your notebook for date and time). This will serve as a final checkup and a time to ask any questions that you might have.
Arrival Time at Hospital
When you have your pre-admission testing done, you will be instructed on what time to arrive at the hospital the morning of your surgery. You will get a reminder phone call from Misty Spano, the Joint Program Coordinator. You will be asked to come to the hospital two hours before the scheduled surgery to give the nursing staff sufficient time to prepare you for surgery. It is important that you arrive on time to the hospital because sometimes the surgical time is moved up at the last minute and your surgery could start earlier. If you are late, it may create a significant problem with starting your surgery on time. In some cases lateness could result in moving your surgery to a much later time.
Parking
Parking is available in visitor lots for free.
Prepare Your Home For Your Return From The Hospital
Have your house ready for your arrival back home. Clean. Do the laundry and put it away. Put clean linens on the bed. Prepare meals and freeze them in single serving containers. Cut the grass, tend to the garden and other yard work. Pick up throw rugs and tack down loose carpeting. Remove electrical cords and other obstructions from walkways. Install nightlights in bathrooms, bedrooms, and hallways. Arrange to have someone collect your mail and take care of pets or loved-ones, if necessary.
The Night Before Surgery
Do Not Eat or Drink
Do not eat or drink anything after midnight, EVEN WATER, unless otherwise instructed to do so. No chewing gum. Please do not smoke 24 hours prior to your surgery.
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Infection Prevention
Please do not shave the operative leg three days prior to surgery. The night before or the morning of surgery, wash the operative leg with an antibacterial soap.
NOTE: If your procedure is in the warmer months, please be cautious of bug bites. Any open area on the operative site could result in surgery cancellation.
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Special Instructions
Follow specific instructions given to you at your physician's office and at your pre-admission testing regarding medications.
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What to Bring to the Hospital
Personal hygiene items (toothbrush, powder, deodorant) comfortable clothes, and well-fitted, slip-resistant shoes.
You must bring the following to the hospital:
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Your patient NoteBook
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A copy of your Advance Directives
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Your insurance card, driver's license or photo I.D., and any co- payment required by your Insurance company
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NOTE:
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Please leave jewelry, valuables, and large amounts of money at home
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Makeup must be removed before your procedure
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Nail polish may be left on
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