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Shoulder Replacement
Indications for operation:
Glenohumeral (shoulder) joint arthritis causing pain which has not responded to conservative treatment

Anaesthetic:
General Anaesthetic with an interscalene block (You will be fully asleep and a local anaesthetic injection into the side of the neck will numb the nerves to the shoulder for post-operative pain relief)

Operation type:
Open

Incisions:
An 8cm incision will be made in the front of the shoulder in the "deltopectoral groove". This runs from just below the clavicle "collar bone" straight down towards the axilla (armpit).

Procedure:
The muscles over the front of the shoulder will be pulled to the side and the subscapularis muscle will be divided to allow access to the joint. The head of the humerus (arm bone) will be shaped and the bone prepared to receive the implant. The face of the glenoid (the body side of the joint) may also be prepared to receive a new surface. The new shoulder joint will be inserted and fixed into place. The tissues will be sewn back to their original positions. A small vacuum drain may be inserted into the joint to allow any blood which collects after the operation to be removed.

A small tube (catheter) will be inserted into the joint at the end of the procedure. This is connected to a pump which will place local anaesthetic into the joint for 48 hours afterwards.

Wound Closure:
A single long dissolving stitch under the skin and paper stitches over the top will be used to close the wound.

Dressings:
Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.

Immediate aftercare:
You will wake up with a sling on the arm and your arm may feel numb for the rest of the day. There will be an IV line (a drip) in your other arm. A vacuum drain may be connected to your operated shoulder. You will need to remain in hospital until the drain is removed and you are comfortable. A physiotherapist will see you and you will be given instructions on what to do next.
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