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healing."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":10,"max":14,"unit":"days","qualifier":"Wound check and suture/staple removal if not absorbable."}},{"purpose":"assessment","requirement":"routine","after":{"min":38,"max":52,"unit":"days","qualifier":"About 6 weeks with X-ray and progression of rehabilitation."}},{"purpose":"result_review","requirement":"routine","after":{"min":80,"max":100,"unit":"days","qualifier":"About 3 months."}},{"purpose":"result_review","requirement":"routine","after":{"min":170,"max":380,"unit":"days","qualifier":"6-12 months review with imaging."}}],"indications":["Advanced glenohumeral osteoarthritis with pain unresponsive to conservative treatment","Rheumatoid or other inflammatory arthritis of the shoulder","Complex proximal humerus fracture or fracture sequelae","Rotator cuff tear arthropathy","Avascular necrosis of the humeral head with joint collapse"],"main_risks":["Infection","Implant loosening or wear over time","Dislocation or instability","Stiffness","Rotator cuff failure (anatomic replacement)","Nerve injury","Periprosthetic fracture","Blood clots","Anesthesia-related risks","Scapular or acromial stress fracture (reverse replacement)"],"pain":"Moderate to severe pain in the first days to weeks, controlled with multimodal analgesia and often a nerve block; gradually improves over several weeks, with long-term pain relief typically better than before surgery.","preparation":["Pre-operative medical assessment and fitness for anesthesia","Blood tests, imaging (X-ray, CT/MRI) and surgical planning","Review of medications with the surgical and anesthesia team","Fasting before general anesthesia as instructed","Smoking cessation and optimization of chronic conditions","Plan home help and sling/one-handed activity arrangements","Screening for infection (e.g., dental, skin)"],"recovery_timeline":[{"phase":"Hospital stay (days 0-2)","description":"Pain control, sling, early gentle movement guided by therapist.","restrictions":["Sling use","No active lifting of the arm"]},{"phase":"Early recovery (weeks 1-6)","description":"Passive and assisted motion, wound healing, sling use as directed.","restrictions":["No lifting or pushing with the operated arm","No driving while in sling or on opioids"]},{"phase":"Active motion (weeks 6-12)","description":"Sling weaned; active range of motion and daily activities resume.","restrictions":["Avoid heavy lifting","Avoid forceful overhead movements"]},{"phase":"Strengthening (months 3-6)","description":"Progressive strengthening and return to light recreational activity.","restrictions":["Avoid heavy repetitive or impact loading"]},{"phase":"Final recovery (6-12 months)","description":"Continued gains in strength and function.","restrictions":["Long-term avoidance of heavy overhead lifting as advised"]}],"rehabilitation_days":{"min":90,"max":180,"unit":"days","qualifier":"Ordinary functional recovery with supervised physiotherapy and home exercises until daily activities are comfortable; strength continues improving later."},"result_longevity":"Many implants function well for 10-20 years or more, but longevity depends on implant type, patient activity, bone quality and indication.","revision_rate_pct":{"min":3,"max":10,"unit":"percent","qualifier":"Revision surgery within about 10 years of primary replacement; lower in first 2 years."},"scars":"A single scar about 10-15 cm, usually along the front of the shoulder (deltopectoral approach); fades over many months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation for a primary one-sided shoulder replacement."},"stages":[{"code":"surgery","label":"Shoulder replacement operation","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery"}}],"qualifier":"Single-stage primary replacement of one shoulder."},"success":{"metric":"Patients with significant pain relief and improved function","value":90,"unit":"percent of patients","horizon":"2 years after surgery","population":"Adults with end-stage glenohumeral arthritis undergoing primary shoulder replacement","evidence_status":"limited"},"techniques":[{"name":"Anatomic total shoulder arthroplasty","suits_whom":"Arthritis with intact rotator cuff and adequate glenoid bone","recovery":"Sling about 4-6 weeks, progressive rehab over 3-6 months"},{"name":"Reverse total shoulder arthroplasty","suits_whom":"Cuff tear arthropathy, deficient rotator cuff, complex fractures, older patients","recovery":"Similar timeline; sling about 4-6 weeks, with specific motion precautions"},{"name":"Hemiarthroplasty","suits_whom":"Selected fractures or avascular necrosis with intact glenoid","recovery":"Similar to total replacement; rehab may be slower if tuberosities need healing"}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1.5,"max":3,"unit":"hours","qualifier":"Operative time for a primary shoulder replacement, excluding anesthesia and 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