Shoulder replacement is a common orthopedic procedure that can help if you are suffering from chronic shoulder pain. Chronic shoulder pain can be the result of degeneration of your shoulder joint, inflammation or trauma. Shoulder replacement involves replacing the ball and socket portion of your shoulder joint with a shoulder implant.

You may need shoulder replacement surgery if you experience loss of shoulder motion, pain, and difficulty with the daily activities of life. These symptoms occur when cartilage on your shoulder joint has worn out from wear-and-tear or injury.

Shoulder replacement with the Catalyst CSR™ Shoulder System may be the right option for you* if you are suffering from:

• Arthritis or chronic pain in your shoulder
• Limited shoulder strength or mobility caused by osteoarthritis, avascular necrosis, rheumatoid arthritis, post-traumatic arthritis, or a functional deformity

*Talk with your doctor about your pain, personal history and desired activity level to determine the best medical treatment plan for you.

BONE-PRESERVING

Traditional shoulder implants require removal of the top of your humerus so a “stem” can be inserted down into the bone canal. The Catalyst CSR™ Shoulder System is fixed without a stem to preserve as much of your strong, healthy bone as possible.

LESS INVASIVE

The Catalyst CSR™ Shoulder System is a less invasive shoulder replacement solution. The design may help to significantly reduce time or exposure to anesthesia and blood loss.

NATURAL SHAPE

The Catalyst CSR™ Shoulder System has a non-spherical design to mimic the shape of the normal human shoulder. Research has shown that shoulder implants designed this way move more like a normal shoulder than traditional spherical shoulder implants.

RAPID RECOVERY

When compared to traditional total shoulder arthroplasty, early data shows that on average, the Catalyst CSR system results in a shorter hospital stay, a smaller readmission rate, and a higher percentage of patients being discharged home instead of to a skilled nursing or inpatient rehab facility. This may lead to a quicker return to normal lifestyle and everyday activities.

“All I can say is WOW. My result with Catalyst is so much better. After the right [traditional] shoulder surgery, I slept in a chair for three weeks. This time [with the Catalyst CSR system], on the very first night after surgery, I slept in my bed the whole night. I felt really good and was virtually pain-free. Three months later, I feel like I haven’t even had surgery. I am able to put dishes away on the top shelf and hang clothes without difficulty or pain. I definitely could not do that at this point after my right shoulder surgery.”

— Annette R.,Edina, MN

Annette is a 68-year-old female who suffered with advanced arthritis in both shoulders. In March 2016, her right shoulder was replaced with a traditional shoulder arthroplasty system. In January 2017, her left shoulder was replaced with a Catalyst CSR system.

You may need shoulder replacement surgery if you experience loss of shoulder motion, pain, and difficulty with the daily activities of life. These symptoms occur when cartilage on your shoulder joint has worn out from wear-and-tear or injury.

Total shoulder replacement replaces both the ball and socket of the shoulder joint. This surgery involves the doctor making an incision approximately 4-6 inches long along the front of your shoulder. The operation takes 1 ½-2 hrs and is performed under general anesthesia with a nerve block to reduce pain after surgery.

The top end of your arm is shaped like a ball. Muscles and ligaments then hold this ball against a cup-shaped part of the shoulder bone. During surgery the doctor will replace the ball and socket joint of the shoulder with a plastic and metal implant. The images shown are two types of shoulder replacement implants. Your physician will decide which type is best for you. These new shoulder surfaces will give you improved motion.

You will awake from surgery in the recovery room with an I.V., bulky shoulder dressing, and a shoulder immobilizer/sling. Once your vital signs are stable and you are fully awake, you will be transferred to your hospital room.

You should be examined by your family doctor to ensure you are healthy enough for the planned surgery. You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Pre-admission testing (lab work, EKG, chest x-ray) will be scheduled prior to your surgery. Medications such as anti-inflammatory medications, aspirin, and blood thinning medications should be stopped one week before surgery unless otherwise specified by your family doctor.

Most people are able to get out of bed with help the day of surgery. Hospital stay is usually 1-2 days. You may be discharged home with nursing services and a therapist to help with your home exercises.

Once home, you are encouraged to be up and walking several times per day for short periods to restore your physical strength. You may be more comfortable resting or sleeping in a recliner type chair.

Home exercises are to be done 6 times per day to prevent shoulder stiffness. Formal physical therapy will begin when instructed by your surgeon usually 1-2 weeks after surgery.

Blood clots: Symptoms of a blood clot include pain, swelling, or redness of your arm, calf or thigh. Call the office immediately if you develop any of these symptoms or go to the emergency room. If you develop sudden shortness of breath go to the emergency room or call 911.

Infection: Infection is rare but can occur following surgery. You are at higher risk if you have diabetes, rheumatoid arthritis, chronic liver disease, or are taking steroids. Symptoms include: drainage, redness, fever, foul smell or increased pain of surgical site.

Blood loss: It is possible you may need a blood transfusion following surgery. Your doctor will evaluate you daily to determine if this is necessary.

Nerve damage: Damage to your surrounding shoulder nerves is rare but can occur. Notify your doctor if numbness or tingling around the shoulder is prolonged or worsens following surgery.

Anesthesia complications: Risk of respiratory failure, shock, cardiac arrest, and death are always possible. Patients with long-term liver, kidney, heart or lung disease are at a higher risk. Nausea and vomiting from the anesthesia are common. Coughing and deep breathing as well as drinking fluids will help flush out the anesthesia gases.

Bone fracture: Although it is rare, a fracture could occur during surgery while fixating the implant.

Pneumonia: Lung congestion is possible following surgery when you are not as active. Coughing and deep breathing is encouraged to help you expand your lungs and clear any congestion.

Constipation: Bowel movements are slowed down with less activity and use of pain medications. Stool softeners will be encouraged after discharge to promote regular bowel movements and prevent constipation.

Dislocation of shoulder: This rarely happens but occurs when soft tissues around the shoulder joint are stretched too soon after surgery.
Recovery PeriodThe average recovery period for shoulder replacement surgery is 4-6 months. Lower impact activities such as walking, biking and swimming are good forms of exercises after your recovery period.

Notify your family doctor if you develop any suspected infections so you can be placed on an antibiotic to prevent the spread of infection to your shoulder joint. Infections such as ear infections, ingrown toenails, bladder infections, sinus infections, and sore throats should be reported immediately. Make sure all of your doctors know you have had a joint replacement so you can be pre-medicated with an antibiotic before any dental work, bladder, bowel or vaginal surgeries or a colonoscopy.

Your sling must stay on at all times (even during sleep) and worn for 4 weeks following surgery. The chest strap wrapped around your body must stay on for the first 2 weeks. Ice to the surgery area (20 min on and 20 min off) will help decrease your pain and swelling.

72 hours following surgery you may remove the dressing and shower but do not submerse your shoulder in water. You are allowed to remove your sling for showering only but keep your surgical arm at the side of your body during the shower. Soapy water may rinse over your surgical site but do not scrub this area. Pat dry the surgical site with a clean towel and leave the incision site open to the air. Do not apply any lotions, ointments, or Neosporin over the incision area.

 You will receive instructions regarding exercises after your surgery.

You may need shoulder replacement surgery if you experience pain, loss of shoulder motion, and difficulty with daily activities of life. These symptoms may be related to arthritis (loss of cartilage) along with a torn or worn out rotator cuff tendon in your shoulder.

The reverse shoulder replacement uses a ball-and-socket joint where the ball is placed on the shoulder blade and the socket is placed on the top of the arm bone. This is reverse of our normal anatomy and is designed to make the deltoid muscle, the large shoulder muscle that caps the end of the shoulder, work better to make up for the deficiency of your worn out rotator cuff tendon.

This surgery involves the doctor making an incision approximately 4-6 inches long along the front of your shoulder. The surgery takes 1 ½- 2 hours and is performed under a general anesthesia with a nerve block to reduce pain after surgery.

You should be examined by your family doctor to ensure you are healthy enough for the planned surgery. You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Pre-admission testing (lab work, EKG, chest x-ray) will be scheduled prior to your surgery. Medications such as anti-inflammatory medications, aspirin, and blood thinning medications should be stopped one week before surgery unless otherwise specified by your family doctor.

Most people are able to get out of bed with help the day of surgery. Hospital stay is usually 1-2 days. You may be discharged home with nursing services and a therapist to help with your home exercises.

Once home, you are encouraged to be up and walking several times per day for short periods to restore your physical strength. You may be more comfortable resting or sleeping in a recliner type chair.

Home exercises are to be done 6 times per day to prevent shoulder stiffness. Formal physical therapy will begin when instructed by your surgeon usually 1-2 weeks after surgery.

Blood clots: Symptoms of a blood clot include pain, swelling, or redness of your arm, calf or thigh. Call the office immediately if you develop any of these symptoms or go to the emergency room. If you develop sudden shortness of breath go to the emergency room or call 911.

Infection: Infection is rare but can occur following surgery. You are at higher risk of infection if you have diabetes, rheumatoid arthritis, chronic liver disease, or are taking steroids. Symptoms include: drainage, redness, fever, foul smell or increased pain of surgical site.

Blood loss: It is possible you may need a blood transfusion following surgery. Your doctor will evaluate you daily to determine this need.

Nerve damage: Damage to your surrounding shoulder nerves is rare but can occur. Notify your doctor if numbness or tingling around the shoulder is prolonged or worsens following surgery.

Anesthesia complications: Risk of respiratory failure, shock, cardiac arrest, and death are always possible. Patients with long-term liver, kidney, heart or lung disease are at a higher risk. Nausea and vomiting from the anesthesia are common. Coughing and deep breathing as well as drinking fluids will help flush out the anesthesia gases.

Bone fracture: Although it is rare, a fracture could occur during surgery while fixating the implant.

Pneumonia: Lung congestion is possible following surgery when you are not as active. Coughing and deep breathing is encouraged to help you expand your lungs and clear any congestion.

Constipation: Bowel movements are slowed down with less activity and use of pain medications. Stool softeners will be encouraged after discharge to promote regular bowel movements and prevent constipation.

Dislocation of shoulder: This rarely happens but occurs when soft tissues around the shoulder joint are stretched too soon after surgery.

The average recovery period for shoulder replacement surgery is 4-6 months. Lower impact activities such as walking, biking and swimming are good forms of exercises after your recovery period.

Notify your family doctor if you develop any suspected infections so you can be placed on an antibiotic to prevent the spread of infection to your shoulder joint. Infections such as ear infections, ingrown toenails, bladder infections, sinus infections, and sore throats should be reported immediately. Make sure all of your doctors know you have had a joint replacement so you can be pre-medicated with an antibiotic before any dental work, bladder, bowel or vaginal surgeries or a colonoscopy.

Your sling must stay on at all times (even during sleep) and worn for 4-6 weeks following surgery. The chest strap wrapped around your body must stay on for the first 2 weeks. Ice to the surgery area (20 min on and 20 min off) will help decrease your pain and swelling.

72 hours following surgery you may remove dressing and shower but do not submerse your shoulder in water. You are allowed to remove your sling for showering only but keep your surgical arm at the side of your body during the shower. Soapy water may rinse over your surgical site but do not scrub this area. Pat dry the surgical site with a clean towel and leave the incision site open to the air. Do not apply any lotions, ointments, or Neosporin over the incision area.

You will receive instructions regarding exercises after your surgery.

You may need shoulder arthroscopy surgery if you are experiencing shoulder pain, limited motion, instability, or stiffness. Surgery is usually recommended when you have failed nonsurgical treatments such as physical therapy, medications, or injections.

Injury, overuse, and age-related wear and tear are responsible for most shoulder problems. Shoulder arthroscopy is an option that may relieve painful symptoms that damage soft tissues surrounding the shoulder joint.

Shoulder arthroscopy surgery involves the doctor making a few small incisions around the shoulder, after using general anesthesia to put you to sleep. Using an eye piece, the doctor can see the inner tissues and surrounding bone of your shoulder on a television monitor. During surgery the doctor can inspect, diagnose, and repair problems in your shoulder.

This procedure will take approximately one hour for the doctor to perform. You will wake up in the recovery room with a bulky shoulder dressing, an IV, and possibly a shoulder sling in place. Once you are awake, taking fluids, and are in stable condition the IV will be removed and you will be able to go home.

You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Lab work and an EKG may be scheduled prior to your surgery. Medications such as anti-inflammatory medications, aspirin, and blood thinning medications should be stopped one week before surgery unless otherwise specified by your family doctor.

You may be more comfortable resting or sleeping in a recliner type chair the first few weeks after surgery. Getting up and walking is encouraged to speed your recovery and reduce your risk of developing a blood clot.

You can expect pain and bruising for at least a week after surgery. Apply ice to your shoulder and take pain medication as prescribed to help with your pain control. You may remove your shoulder dressing 48 hours after your surgery. Your sling may be discontinued at the discretion of your surgeon.

Blood clots: Symptoms of a blood clot include pain, swelling, or redness of your arm, calf or thigh. Call the office immediately if you develop any of these symptoms or go to the emergency room. If you develop sudden shortness of breath go to the emergency room or call 911.

Infection: Infection is rare but can occur following surgery. Symptoms include fever or chills, drainage, redness, a foul smell or increased pain at incision sites. You are at higher risk for infection if you have diabetes, rheumatoid arthritis, chronic liver or kidney disease, or are taking long term steroids.

Nerve damage: Damage to your surrounding shoulder nerves is rare but can occur. Notify your doctor if numbness or tingling around the shoulder is prolonged or worsens following surgery.

Anesthesia complications: Respiratory failure, shock, cardiac arrest, and death are always possible during surgery. Patients with long-term kidney, heart, or liver disease are at a higher risk. Nausea and vomiting from the anesthesia are common. Coughing and deep breathing as well as drinking fluids will help flush out the anesthesia gases.

Bleeding inside the joint: Trauma to arteries or veins surrounding the shoulder is rare, but may occur. It is common for some bruising and discoloration to appear around the shoulder and down the arm following surgery. Bright bloody drainage from your incision sites is not common and the doctor should be notified.

The average recovery period for shoulder arthroscopy surgery is 2 weeks to 6 months depending on the specific type of procedure performed. Most patients are back to work within a week if the job is sedentary; however, it may take longer if the job is labor-intensive. 

Showering is permitted 48 hours after surgery. Soap and water may be applied to incision site area. Do not scrub or soak these incision sites or apply any lotions, ointments, or Neosporin. Pat dry incision sites following the shower and keep sites open to air.

Depending on the surgery performed, you may be instructed to perform the following exercises.

Please perform the following exercises 6 times/day for 2 minutes each.

Stir the paint: Remove your sling and stand at a counter or table top. Bend forward and let your surgical arm dangle. Slowly move your arm in a circular motion as if you were stirring a can of paint. Repeat exercise going the opposite direction.

Handshake: Remove your sling and keep your elbow tucked in at your side. Move your surgical arm outward until you reach 90 degrees or a handshake position. Do not go over 90 degrees or move your elbow away from the side of your body.

Wall walkers: Remove your sling and stand facing the wall. Take your surgical arm and use your fingertips to crawl up the wall as high as you can reach.

An MRI scan or ultrasound, along with a history and physical exam, are the most common ways used to evaluate the shoulder. Rotator cuff tears may cause pain and weakness in the affected shoulder. Most people say they are unable to sleep on the affected side due to the pain. In some cases, a rotator cuff may tear only partially. Partial tears may be painful but you can still move your arm normally. Certain types of partial rotator cuff tears may not require surgical repair and your physician may want to consider non-surgical options that may include: limiting activities, anti-inflammatory medications, physical therapy or an injection of a steroid medication into the shoulder joint.

In general, the larger the tear, the more weakness it causes. A complete tear generally makes it impossible to move the arm normally. It can be difficult to raise your arm away from your side by yourself. A complete rotator cuff tear will not heal and will require surgery if your goal is to return your shoulder to optimal function.

The surgery is done as an outpatient under general anesthesia and will take approximately 1 ½ hours. You may also receive a nerve block injection into your shoulder which will help with pain for several hours following the surgery. The surgeon will make approximately 3-5 small incisions (1/4 inch long) along the front, back and side of your shoulder. He will use these incisions to insert the arthroscope and several other tools. The arthroscope is a small camera device that allows the surgeon to look into the shoulder joint. He can insert tools to trim and remove the degenerative tissue and bone. The torn rotator cuff tendons are repaired by inserting suture anchors into the bone allowing for a strong attachment of the tendon to the bone. This will keep the tendon close to the bone allowing it to heal back to the bone.

You will awaken with a bulky dressing on your shoulder and a sling/immobilizer in place. Once you are awake, taking fluids, and are in stable condition, the IV will be removed and you will be discharged.

You are encouraged to stop smoking before surgery to prevent lung complications or delayed healing. Lab work and an EKG may be scheduled prior to surgery. Anti-inflammatory medications, aspirin and blood-thinning medications should be stopped one week before your surgery unless otherwise specified by your family doctor. These medications affect your blood clotting ability and could increase your risk for bleeding. Please bring the shoulder immobilizer with you the day of surgery.

The nerve block you may have received during surgery will generally minimize pain for about 12-18 hours after surgery. The use of oral pain medications will be needed after the block has worn off. Expect significant pain for the first few days after surgery. The use of ice to your shoulder for the first week is very important. The bulky surgical dressing can be removed after 24-72 hours, depending on your physicians’ preference. You may then shower but do not submerge your shoulder in water. Remove your sling but keep your arm close to your side while showering. Do not apply lotion or antibiotic ointments to your incisions. You may keep your incisions open to the air if they are not draining, or apply clean dry band aids daily. You may be more comfortable resting or sleeping in a recliner type chair. You will have an appointment to see your surgeon in the office 2 weeks after surgery and any sutures will be removed. It is very important that you only remove your sling/immobilizer for showering and for passive exercises for the first 4 to 6 weeks.

Blood clots: Symptoms of a blood clot include pain, swelling or redness of your arm, calf or thigh. Call the office immediately if you develop any of these symptoms or go to the emergency room. If you develop sudden shortness of breath go the emergency room or call 911. The easiest way to help prevent blood clots is frequent walking following surgery.

Infection: Infection is rare but can occur following surgery. Symptoms include fever or chills, drainage, redness, a foul smell or increasing pain at the incision sites. Please contact our office if you experience any of these symptoms or have concerns. You are at a higher risk for infection if you have diabetes, rheumatoid arthritis, chronic liver or kidney disease, or if you are taking steroids.

Nerve damage: Damage to the nerves that surround the shoulder is rare but can occur. Notify your doctor if numbness and tingling around the shoulder is prolonged or worsens following surgery.

Anesthesia complications: Respiratory failure, shock, cardiac arrest and death are always possible during surgery. Patients with long-term kidney, heart, liver, or lung disease are at a higher risk. Nausea and vomiting from anesthesia are common. Coughing, deep breathing and drinking fluids will help to flush out anesthesia.

Bleeding: Trauma to the arteries and veins surrounding your shoulder is rare but may occur. Please contact our office if your surgical dressing becomes saturated with blood. It is common to have some bruising and discoloration around the shoulder and upper forearm.

It is important that your elbow stay close to your side when your sling/immobilizer is off for the first 6 weeks after surgery. Your surgeon will advise you when he wants you to begin formal physical therapy, which could begin immediately following surgery or not until 6 weeks after surgery. Rehabilitation after rotator cuff surgery can be a slow process. Getting the shoulder moving with simple passive exercises as soon as possible is important, however this must be balanced with the need to protect the healing tissues with the use of the sling/ immobilizer. The first 12 weeks following surgery are focused on regaining motion in your shoulder with a progression in exercises/therapy. You will not begin any strengthening or resistance type exercises until 12 weeks following surgery.

Patients may return to work after they see their physician 2 weeks following surgery but will be restricted to only using their non-affected arm. Patients generally have work restrictions for 12 weeks following surgery. Patients with labor intensive jobs may have restrictions beyond 12 weeks. You will be restricted from driving for 6 weeks after surgery or until your physician has allowed you to discontinue wearing your sling/immobilizer.

Exercises will be dictated by the size of your rotator cuff tear. You will receive instructions regarding exercises after your surgery.