I thought I would post about my experience with hopes it will help someone else.
I was in a motorcycle wreck in 1977 and shattered my shoulder. It damaged a lot of soft tissue because of the bone shards and also healed incorrectly. I developed arthritis and also avascular necrosis which is where parts of the bone don't get adequate blood supply so it dies, gets brittle and breaks apart, deforming the bone and leaving debris floating in the joint. The cause of the AV was damage to blood vessels from the accident.
By the 1990s I was having lots of trouble with my shoulder, both pain in the joint and persistent muscle spasms. I tried a lot of things but a hot tub helped the most and kept me functioning. In 1996, I had laser surgery to clean things up and that helped for a while.
In 2004, at age 45, I had the partial replacement where they put a cap on the ball part of the shoulder. My bone was in really bad shape, deformed to the point that my surgeon said it wasn't recognizable as a shoulder anymore - "a square peg in a round hole". The cap was to give me some more time before I would have to have full joint replacement.
I'll say here that I read at that time that the choice of surgeon was the most critical key to a successful surgery. Docs who do a lot of replacements get better outcomes, shorter hospital stays and fewer complications. So I got the best I could and saw Dr. John Brems who heads the Shoulder Orthopedic group at the Cleveland Clinic and does over 400 replacements a year. He has been doing them since the 1980s so the guy can practically do them in his sleep. He also has a sweet setup with an office next door to a hospital that specializes in orthopedic surgery. All of the patients on my floor were joint replacement patients and the nurses and other personnel are trained specifically for those situations. Cleveland is 6 hours from my home but it is well worth it to get that level of care for something so important to my quality of life.
The partial went well and I recovered relatively quickly (it still took a year). However, I was still badly affected by the soft tissue damage and was restricted in my use of the arm because of that - raise arm no higher than shoulder, lift no more than 10 lbs., keep repetitive motion to a minimum, etc.
Slowly, the pain came back in my shoulder and eventually got really bad. My docs at home didn't think it was a surgical situation and I tried everything for it but nothing worked for long - meds, shots, pt, etc. I spent a year at those things before I finally went back to the surgeon. He told me the xrays showed I had no cartilage left so it was metal on bone and time for the full replacement.
THIS IS IMPORTANT: In some people but not all, the metal cap causes quicker degeneration of the remaining cartilage and bone than would happen without it. If you have the cap done, be sure to be checked every couple of years to see how things are going.
I had the full replacement done on Jan. 18. 2012. Things were a lot worse than the xrays showed. The bone on the socket side was worn down to the point that there was barely enough bone to attach the prosthesis even though he used the smallest one they make. If I had waited even just a couple of more months, there would not have been enough bone and I would have had to have a series of bone graft surgeries before the joint was replaced - can you imagine? I am so grateful. Even so, it means that if I need a revision, I will have to go through that because removing the current prosthesis will destroy what little bone is left. I am only 53 so my use of the arm will be restricted to make the joint last as long as possible and many activities will be eliminated because of risk of injury. I simply can't afford even a minor injury. As the doc put it, there are no do-overs or fixes at this point. He said that my shoulder was one of the worst he has ever seen and also one of the most difficult surgeries he has ever done. He had trouble on the ball side too because the bone was so small and the scar tissue and other soft tissue damage was so bad that he had trouble distinguishing the different tissues and structures during the surgery. Really, it is amazing that my arm works at all and I believe a lot of it is because I have a top surgeon taking care of me.
Even with all of that, my recovery has gone extremely well. There was very little bruising, drainage or swelling. I was released after 2 days in the hospital and sent home with a Q-on Nerve block pump which was wonderful for pain control and for physical therapy.
As with the earlier surgery, I was told not to wear my sling except when out in public when I need it to shout to people not to bump me or touch my shoulder. My physical therapy is my husband moving my arm for me in 2 types of movement morning and night plus me doing the passive pendulum movement. I was told to take my meds and put a heating pad on 1/2 hour before doing the pt and have followed those instructions (and all others) to the letter. Since getting my stitches and staples out, I have been getting in the hot tub before pt because that warms the muscles even more. I will not see a professional physical therapist during this recovery and didn't during the last. My doc will give us the instructions and we will follow them, simple as that.
Here are some of my tips:
I wear elastic waist pants and zip-up light-weight hoodies every day with a fasten in front, no wire, "sleeping" bra which has never been a problem. I bought a cheap pair of tennis shoes at Walmart that has velcro closures so that I can manage them easily.
We put a folded blanket and pillow on our dining room table and that is where we do my pt. My husband has bad knees and by using the table, he can do the exercises without stressing his body. I have a stretchy cheap turban from the beauty supply store that I can pull over my head and then stuff my hair into it so that I can get in the hot tub or bath tub while keeping my hair dry. I tried other things but the turban was the only thing that let me manage my hair on my own.
I sleep in a recliner on my back but with my weight shifted onto the hip on the opposite side of the surgical shoulder. This puts the weight of my upper body to that side so that my surgical shoulder isn't pushed back against the recliner. I lay a rather flat but wide (queen size?) bed pillow across my lap and put my arm on it, then pull it up so that it is across my chest as I lay back and my arm is draped over it in a bent position. This keeps my arm forward across my body so that it can't fall back to where the elbow is further back that the front of my body which would cause a lot of problems. I use a squishy little pillow for my head and manage to sleep pretty well.
I take my meds around the clock, setting an alarm so that I won't forget. It is a lot easier to keep the pain under control than to get it under control in the first place.
I stocked up on microwaveable meals and other foods that I can manage with one arm. I was encouraged to use the surgical arm as long as I kept my elbow against my body and didn't lift any weight or push or pull things and now, 3 weeks after surgery, I can reach out far enough to wash my hands normally and am now typing with the keyboard on my lap. I am careful not to hurt myself but do use the arm as I can.
I sleep a lot, read, mess around on the internet, etc. so life is pretty boring. The pain gets bad at times but is mostly well managed. I get frustrated and/or down at times but not for long. I knew it would be like this because it takes 6 weeks just for the tissues to heal before you can even begin to get any strength back. Recovery, at least for the first 6 weeks, is mostly a waiting game. It seems like you aren't doing much but your body is hard at work healing itself.
That is all that I can think of right now except to say that rehab is the key to recovery and a good outcome as far as function is concerned. You have to do the rehab as instructed, devotedly, but it will be worth every minute.
I hope this helps someone. If you have questions, I will do my best to answer them.