SHOULDER REPLACEMENT SURGERY
What is a Shoulder Replacement Surgery?
Shoulder Joint Replacement involves surgery to replace the ends of bones in a damaged joint. This surgery creates new joint surfaces.
In shoulder replacement surgery, doctors replace the ends of the damaged upper arm bone and usually the shoulder bone (scapula) or cap them with artificial surfaces lined with plastic or metal and plastic. Shoulder joint components shoulder replacement surgery India, shoulder replacement surgery, surgery for shoulder replacement may be held in place with cement or they may be made with material that allows new bone to grow into the joint component over time to hold it in place without cement.
The top end of your upper arm bone is shaped like a ball. Muscles and ligaments hold this ball against a cup-shaped part of the shoulder bone. Surgeons usually replace the top of the upper arm bone with a long metal piece, inserted into your upper arm bone that has a rounded head. If the cup-shaped surface of your shoulder bone that cradles your upper arm bone is also damaged, doctors smooth it and then cap it with a plastic or metal and plastic piece.
What causes for shoulder pain?
The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from one or more of the following causes:
- Strains from overexertion
- Tendonitis from overuse
- Shoulder joint instability
- Collar or upper arm bone fractures
- “Frozen” shoulder
- Pinched nerves (also called radiculopathy)
For many shoulder conditions involving the surrounding ligaments, muscles and tendons, such as a torn or diseased rotator cuff or a labral tear, a minimally invasive shoulder arthroscopy procedure is frequently recommended, and they are among the most common and frequently indicated shoulder procedures. Total shoulder replacement, however, requires open surgery, with an incision along the front of the shoulder and upper arm.
What are Shoulder Injuries in Baseball?
Spring brings baseball and softball season and a time for the athlete to take heed of injuries that can occur in the throwing shoulder. The athlete may start by complaining of shoulder pain that is present only when throwing and for a short time afterward however, the shoulder pain may progress to where it is present before, during and after activity. The athlete eventually becomes unable to throw at all due to the pain in the shoulder.
Rotator cuff tendinitis occurs when the tendon becomes irritated and inflamed as it rubs on the undersurface of the shoulder. Similarly, bursitis results from the repeated pinching of the bursae between the shoulder structures, putting additional pressure on the already-inflamed shoulder area. The combination of tendinitis and bursitis may result in impingement in the shoulder. Symptoms include pain and weakness with overhead arm movements.
Subluxation is where the shoulder slips partially out of joint and then returns to its original position, causing instability of the shoulder joint. This is often related to fatigued muscles in the shoulder.
Since they are primarily related to overuse, these conditions can be relieved by resting the shoulder to provide time for healing; by strengthening, stretching and building muscular endurance; and using a throwing program that includes a warm-up and a gradual return to throwing after a long layoff. Athletes may be able to avoid further injury that may result in shoulder surgery by following these guidelines.
What are the Symptoms for Shoulder Replacement Surgery?
The most characteristic symptom of shoulder instability is a sense that the shoulder is about to come out of place or that the shoulder has jumped back into its socket. This sensation may or may not be accompanied by pain, but it is typically uncomfortable. Occasionally, a person may feel numbness or a tingling down the arm.
In addition, the patient may experience clicking, catching or looseness of the shoulder with daily activities and particularly with sports that require overhead throwing or swimming.
Sometimes, the ball of the joint will separate completely from socket, and the ball will not spontaneously fall back into place. Severe pain, deformity of the shoulder and a sense of paralysis of the arm may occur as a result. Manipulating the arm into place may require physician assistance.
How is neck and shoulder pain diagnosed?
X-rays can be helpful in diagnosing neck and shoulder pain. Plain X-rays can reveal disc space narrowing, rheumatologic disease, destructive lesions, slippage, stenosis, fractures, and instability with flexion-extension views.
- Magnetic resonance imaging (MRI) is a non-invasive procedure that can reveal the detail of neural (nerve-related) elements.
- Myelography / CT scanning are sometimes used as an alternative to MRI.
- Electrodiagnostic studies—electromyography (EMG) and nerve conduction velocity (NCV)—also might aid in the diagnosis of neck and shoulder pain, arm pain, numbness, and tingling.
How is neck and shoulder pain treated?
The treatment of soft tissue neck and shoulder pain includes the use of anti-inflammatory medicine and/or acetaminophen (Tylenol). Pain also might be treated with a local application of moist heat or ice. A local corticosteroid injection is often helpful for arthritis of the shoulder. For both neck and shoulder pain movement exercises can have positive results. For cases in which nerve roots or the spinal cord are involved, surgical procedures might be necessary.
What is Shoulder Anatomy?
Similar to the hip joint, the shoulder is a large ball and socket joint. It is made up of bones, tendons, muscles and ligaments which hold the shoulder in place but also allow movement. Bones of the shoulder joint include: the clavicle (collar bone), scapula (shoulder blade), and humerus (arm bone). The clavicle attaches the shoulder to the rib cage and holds it out away from the body. The clavicle connects with the large flat triangular bone, the scapula (shoulder blade) at the acromioclavicular joint (A.C. joint or the acromion). The rounded head of the humerus, or arm bone, rests against the socket in the shoulder blade.
In a total shoulder replacement, a metal ball is used to replace the humeral head while a polyethylene cup becomes the replacement of the glenoid socket. The primary indication for a total shoulder replacement is pain which will not respond to non-operative treatment. Pain may be the result of abnormalities and changes in the joint surfaces as a result of arthritis or fractures.
The primary goal of total shoulder replacement surgery is to alleviate pain with secondary goals of improving motion, strength and function.
What are the Types of Shoulder Replacement?
The two most common types of shoulder replacement are an anatomic shoulder replacement and a reverse total shoulder replacement.
With Conventional or Anatomic Total Shoulder Replacement, the ball (humeral head) of the shoulder joint is replaced with an implant that includes a stem with a smooth, rounded metal head. The socket (glenoid) is replaced with a smooth, specialized plastic that is cemented into place. In essence the diseased cartilage is removed and resurfaced with the two components. In some cases just the ball is replaced, which is called a partial replacement or hemiarthroplasty.
With Reversed Total Shoulder Replacement, the normal structure of the shoulder is “reversed”. The ball portion of the implant is attached to the scapula (where the socket normally is) and the artificial socket is attached to the humeral head (where the ball normally is). This allows the stronger deltoid muscles of the shoulder to take over much of the work of moving the shoulder, increasing joint stability. A reversed procedure is use for patients with a severely torn and compromised rotator cuff. It is also commonly used in revision surgery cases.
What is the procedure for Total Shoulder Replacement?
Total Shoulder Joint Replacement is an option given to patients who suffer from joint dysfunction. This is usually the result of osteoarthritis or rheumatoid arthritis, but more rarely for those who have sustained severe trauma from a shoulder fracture. Generally, all other modes of treatment are considered first, such as physical therapy and medication, but total shoulder replacement can provide pain relief.
Total Shoulder Replacement Arthroplasty is a well-established surgery for restoring comfort and function to the arthritic shoulder. In this procedure the arthritic ball is replaced by a smooth metal ball fixed to the arm bone by a stem that fits within it. The arthritic socket is resurfaced with high-density polyethylene prosthesis in Hyderabad. Among the different surgical options this procedure appears to provide the most rapid and complete improvement in comfort and function for shoulders with arthritis.
What are the general instructions after surgery?
At the time of your hospital discharge, sutures and staples will remain in the shoulder incision. Until the sutures and staples are removed:
- Keep the incisional area dry (no showering or bathing of the area).
- Check the incision daily for increased swelling or drainage.
- Don’t use spray deodorant (you may use the roll- on type).
- Call your physician’s office with any concerns
At discharge, you will be given a return appointment, 10-14 days later for suture removal as well as a prescription for pain medication.
- Your physician will advise you of specific precautions and the limitation of activity.
- General instructions include the following:
- Drive as instructed by your physician. You will, however, need a driver available to take you home at the time of discharge.
- Limit lifting heavy objects for two months.
- Resume active movement of arm within limits of pain.
- Continue exercises at home as instructed by your physical therapist and physician.
Who should consider Shoulder Replacement?
Shoulder replacement surgery is considered when:
- The shoulder arthritis is a major problem that negatively impacts ones quality of life,
- One is sufficiently healthy to undergo the procedure,
- One understands and accepts the risks and alternatives,
- There is sufficient bone and tendon to permit the surgery, and
- The surgeon is experienced in the technique of shoulder replacement.
What happens without surgery?
The natural history of arthritis is that it usually continues to progress over time. The rate of progression varies between individuals and is unpredictable. Sometimes the pain and stiffness from shoulder arthritis will stabilize at a level that is acceptable and manageable to the patient. In general, this surgery is elective, and can be performed whenever the patient decides that the arthritis has become disabling enough to warrant treatment. In the case of osteoarthritis delaying surgery typically does not compromise the success of surgery in the future.
Patient Name: Dr. Venkatesh
Department: Orthopedic and Sports injuries
Treating Doctor: Dr. Sunil Apsingi
Designation: Sr. Consultant Orthopedics Surgeon
Treatment: Shoulder Joint Replacement Surgery