Copeland Resurfacing Shoulder hemiarthroplasty
PROCEDURE: You may have a painful shoulder which has decreased movement. This is usually because of arthritis. You may alternatively have broken the bone.
The surgeon has suggested that a half replacement of the shoulder joint (called a Copeland hemiarthoplasty) is one way to increase the movement in the shoulder and lessen the pain.
The shoulder is a ball and socket joint. In this procedure, the surgeon will try and replace the ball, while leaving the socket as it is.
Your surgeon, or one of the team will visit you before the procedure. They will mark your shoulder so the correct side is operated on. This is the best time to bring up any questions you may have.
While you are asleep in theatre, the surgeon will clean your skin with antiseptic and surgical drapes (towels) will be placed around the shoulder.
Most surgeons will make a downward cut at the front of the shoulder to get to the joint. The arm bone will be released from the shoulder and the top of the head (the ball) is resurfaced with a metal one.
The shoulder can then be relocated (put back into position) and the muscle, tendons and skin closed.
Some surgeons will use dissolvable stitches under the skin. Others will use stitches above the skin which will need to be removed in 10 – 14 days.
When you wake up, you will feel sore and will have a lot of bandage around the shoulder. This is normal. Your surgeon will tell you when this may be removed.
You may also be visited by a physiotherapist. They will show you exercises to better the final range of movement you get. It is important to try and do as much or as little as they suggest.
***Please be assured that all private operations are carried out by a consultant***
ALTERNATIVE PROCEDURE: There are various non-surgical options. You may have explored these already.
They include pain control – including tablets or injections with medicines such as ibuprofen or steroids.
Physiotherapy – learning exercises or stretches has often been proven successful at preventing the need for surgery.
There are other surgical options and other types of shoulder replacements available. You should discuss these with your surgeon.
RISKS
As with all procedures, this carries some risks and complications.
COMMON (2-5%)
Pain: the procedure does involve moving soft tissue and will hurt
afterwards. It is important to discuss this with the staff and
ask for pain killers if needed. The shoulder may remain
stiff for some time afterwards.
Bleeding: there will inevitably be some bleeding. The drains (if present) will limit the amount of collection. If the bleeding is excessive, you may need a blood transfusion.
Scar: the operation will leave a thin scar on the front of the shoulder/
chest
LESS COMMON (1-2%)
Dislocation: this is a painful situation where the shoulder moves out of its
position in the joint. It can usually be repositioned, but if it
happens regularly, a further operation may be necessary.
Decreased function: the success of the operation is very variable. You may end up
with as much or even worse movement in the shoulder. The
main purpose of the operation is to reduce your pain.
Infection: This is may present as redness, discharge or temperature around the flap or donor site. A course of antibiotics may be necessary once the source has been isolated. The
shoulder replacement may also have to be removed and
replaced. This will certainly require further operations.
RARE (<1%)
Nerve damage : there are a great number of large and important nerves that
run through and around the shoulder. These may be damaged
during the operation. This may result in a temporary or more
permanent loss of power or feeling.
Hypertrophic/ keloid scar: These are scars which grow excessively (within the wound margin and beyond respectively). They occur in some people and can not be predicted although if you have a previous keloid scar you are at greater risk. Scars may be treated with steroid injection or surgically if necessary.
Delayed wound healing: may occur if the wound is under
tension, infected or short of blood supply.
Fat necrosis: this is also a cause of delayed wound healing