Shoulder Replacement –Total (Includes Implants & Hardware)
Total Shoulder Replacement
Surgery is to replace the ends of the bones in a damaged joint. This surgery creates new joint surfaces. In Total Shoulder Replacement Surgery, doctors replace the ends of the damaged upper arm bone (humerus) and usually the shoulder bone (scapula) or cap them with artificial surfaces lined with plastic or metal and plastic. Shoulder joint components may be held in place with cement.
Preparation for Total Shoulder Replacement Surgery
Depending on your age and overall health, your surgeon may have you get a thorough physical examination done by your general physician, or if you have heart disease, you will need to get checked by your cardiologist. Your surgeon may also order pre-surgery tests such as:
• Urinalysis
• Chest X-ray
• EKG
• ECG
• Blood tests (depending on your medical history)
You should discontinue use of any anti-inflammatory medication, including aspirin, one week before surgery. Check with your doctor before discontinuing use of any medication.
FAQS
Frequently asked questions about surgical procedures
Can I use my insurance and get these prices?
Payment is due 14 calendar days prior to your surgery date. If, after the cutoff, your account is not settled, your case must be postponed.
How quickly can I have surgery?
How will I meet my surgeon?
If I had a car or work accident, would you work with my employer or attorney for payment?
What if I get sick right before my surgery?
You could develop a respiratory infection, a urinary tract infection, COVID, or some other condition that may necessitate postponement. There is no penalty when this happens.
What’s Included:
- Facility fee
- Graft and hardware costs (if needed)
- Surgeon and assistant surgeon fees
- Anesthesiologist
- Time in the recovery unit (at no additional charge)
- Initial consultation visit
- One post-operative visit
*Please note: If you choose not to proceed with surgery after the initial consultation, or if you delay your procedure for more than 6 weeks, you will need to update your consultation at a cost of $375.
What’s not included:
- Lab testing before and after the surgery, as needed
- Electrocardiogram (EKG), depending on age. If you had one elsewhere in the past 6 months and it read “normal”, we can forego this expense.
- Imaging costs. X-rays and MRIs can be obtained anywhere.
- Physical therapy services
- Medications you’ll need (oral or IV antibiotic infusions if an infection arises)
- Wound care
- Bracing supplies
- Additional doctor visits (a pre-operative visit with the surgeon, in person, and any required post-op follow-ups after the suture removal to monitor your progress
- Additional surgical intervention if a complication arises
- Additional imaging or hospital care if a blood clot develops
Before Your Operation
Wear loose-fitting clothes and a button-front shirt when you go to the hospital for your surgery. After surgery, you will be wearing a sling and will have limited use of your arm.
Total Shoulder Replacement Surgery
The procedure starts with a 4-6 inch incision on the front of the shoulder from the middle of your collarbone to the middle of your arm. This allows access to the shoulder joint without harming the deltoid or pectoral muscles that are used for the shoulder’s power. The procedure involves the removal of the damaged shoulder joint and replacing it with metal and plastic implants. If the socket is unaffected or can be repaired, a hemiarthroplasty may be performed, replacing only the ball of the humerus. In a Total Shoulder Replacement, the socket of the scapula is also replaced. The ball is replaced by a half-moon-shaped metal implant that may or may not be cemented into place; the socket is replaced with a plastic socket that is fixed into the scapula with bone cement.
When the procedure is complete, tendons and ligaments are secured or repaired. Then the incision is closed with either stitches or staples, covered with a bandage, and your arm immobilized with a sling. The repair requires protection from active use for at least 6 weeks. Procedures usually take about 2 hours; however, due to preoperative preparation and postoperative recovery time, you can expect about 6 hours for the entire process.
Cystoscopy Procedure
At this point, you’ll be given anesthesia. If you get general anesthesia, this will be all that you are conscious of until you wake up. If you’re getting a local or regional anesthetic, you may be given a sedative to relax you. Your urethra will be numbed with an anesthetic spray or gel. You’ll still feel some sensations, but the gel makes the procedure less painful. The doctor will lubricate the scope with gel and carefully insert it into the urethra. This may burn slightly, and it may feel like urinating. If the procedure is investigatory, your doctor will use a flexible scope. Biopsies or other surgical procedures require a slightly thicker, rigid scope. The bigger scope allows surgical instruments to pass through it. Your doctor looks through a lens as the scope enters your bladder. A sterile solution will flow through to flood your bladder. This makes it easier for your doctor to see what’s going on. The fluid might give you an uncomfortable feeling of needing to urinate. With local anesthetic, your cystoscopy may take less than five minutes. If you’re sedated or given general anesthesia, Cystoscopy is a test that allows your doctor to look at the inside of your bladder and urethra. It’s done using a thin, lighted tube called a cystoscope; the entire procedure may take 15 to 30 minutes.
What to expect after your surgery
Right after surgery
- You will have intravenous (IV) antibiotics for about a day after surgery. You will also receive medicines to control pain and perhaps medicines to prevent blood It is not unusual to have an upset stomach or feel constipated after surgery.
- When you wake up from surgery, you will have a bandage on your shoulder and probably a drain to collect fluid and keep it from building up around your joint. You may have a catheter, which is a small tube connected to your bladder, so you don’t have to get out of bed to urinate. You may also have a compression sleeve on your arm. This sleeve squeezes your arm to keep the blood circulating and to help prevent blood clots.
- A physical therapist may begin gentle exercises of your shoulder on the day of surgery or the day after. These exercises are just passive motion, which means you relax and let the therapist move your arm for you.
- Most people who have shoulder replacement surgery are able to sit up and get out of bed with some help later on the day of surgery.
- Your doctor may teach you to do simple breathing exercises to help prevent congestion in your lungs while your activity level is reduced
The risks of Total Shoulder Replacement Surgery include
As with any surgery, there are risks of having complications. The risks vary from person to person. That’s because each person’s health status is different, as well as the type of shoulder replacement they will need. The most common problems after shoulder replacement include:
• Infection (most susceptible within the first two years)
• Stiffness in the shoulder – following your physical therapy routine can help prevent stiffness
• Instability in the glenohumeral joint
• Component failure or loosening requiring more surgery
• You may not get complete pain relief
• Rotator cuff tears
• Fractures in the joint
• Deep vein thrombosis
• Pneumonia
• Dislocation – most likely to occur during the healing process, which is why it’s important to wear the shoulder immobilizer
• Nerve injury
• Detachment of the deltoid muscle
Can I Travel to St George for Surgery?
Yes, and we’ll help you make all your arrangements.
- We have arrangements to try to obtain free flights through a non-profit volunteer pilot organization. We can do this with 10 days’ advance notice in most cases.
- We have discount codes for the Holiday Inn in town. This hotel is 1.5 miles from the surgery center and 2 miles from our clinic.
- We’ll arrange to send your after-surgery medications to your hometown pharmacy for pickup before you leave.
What if I would rather drive to St George?
No problem, we can help with those plans as well. When you have surgery with us, we’ll need to make sure you’re safe and comfortable after surgery. We’ll arrange cold compression therapy that requires an AC/DC adaptor/transformer and frequent stops to stretch and refill the ice reservoir on the road.
We’ll ask about the vehicle you’ll travel in to ensure you have a way to elevate and stretch out in the vehicle on the road while someone else does the driving.
How are follow-up and initial consultations handled?
In-person and telehealth consultations are possible with the surgeon to whom your case is assigned. The initial visit is included in the surgical package and is valued at $375.
We can also obtain the flights from the volunteer pilot nonprofit if you’d like to come for initial and follow-up visits in person. One follow-up visit is included in the surgical package at a value of $175. Any additional visits are charged at the time of service to your credit or debit card.
Transparent Pricing Guide
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