What kind of complications may occur?

All operations involve an inherent risk – complications can also occur with shoulder prosthesis operations. The advantages offered, however, are usually argument enough for this surgical intervention: patients normally regain significant quality of life after shoulder prosthesis surgery.

Injury to bones

During the operation the humerus or shoulder blade may be injured. Depending on the bone structure and the care taken by the surgeon, hairline cracks or indeed larger bone fractures may appear in the bones. These may require further surgery to be stabilised, in such cases this extends the postoperative treatment time.

Postoperative bleeding and effusions of blood

Directly after the operation, bleeding or effusions of blood may occur in the wound region. For this reason, a small tube, a so-called Redon drain, is generally placed in the wound which allow the secretions and blood to drain away. This can be removed two to three days after the operation.

Thromboses and embolisms

Thrombosis refers to the formation of a blood clot in a blood vessel. As a consequence, small components can become released and block the blood vessels in the lungs (embolism). In the case of surgical interventions, the risk of thrombosis is primarily increased by confinement to the bed. Thus measures to prevent thromboses are taken, and these include anti-thrombosis injections and compression stockings.

Wound-healing impairment

In addition to the incision in the skin, the subcutaneous tissue structures also have to heal. In such cases, so-called wound-healing impairment may be experienced whereby the wound takes longer to close, and this is associated with intense pain and inflammation.

Infection

There is an increased risk of infection during and after surgery. For this reason, nowadays bone cement which includes an antibiotic is used for the majority of shoulder prosthesis operations. This reduces the risk of infection with the endoprosthesis.

Question: Can other infections in the body affect the endoprosthesis?: Bacterial infections can spread via the bloodstream which can also reach the artificial joint where they may cause an inflammation. All patients with a prosthesis face a higher risk of a prosthesis infection as a result of minor infections of the bladder, tooth roots and sinuses, etc. At the first sign of an infection, patients are advised to consult their family doctor; in the majority of such cases antibiotics are required to prevent the bacteria from spreading.

Prosthesis luxation

Certain movements or a fall can cause the humeral head to come loose from the glenoid cavity – the joint is dislocated and this is referred to as prosthesis luxation. It results in intense pain and an inability to move the shoulder. Since resetting the shoulder joint is painful, this is usually done under anaesthetic.

Premature loosening of the prosthesis

Infections or mechanical problems may cause a prosthesis loosening in the bone just a few weeks or months after the shoulder prosthesis operation. This manifests itself in pain and restricted mobility and, in part, signs of inflammation such as fever and listlessness.

Antibiotics can be used to fight the infection but in the majority of cases the damaged shoulder endoprosthesis must be replaced with a new one in a second operation.

Question: How long can a shoulder endoprosthesis remain in the body?: The life of all shoulder endoprostheses is limited – as a rule they last around 15 years; although a prosthesis can remain in the human body for 20 or more years. Ultimately, its fixation becomes loose and the prosthesis then causes problems such as pain and restricted mobility. A second operation in which the old worn prosthesis is replaced with a new one is then performed.