Shoulder arthritis is characterised by the degeneration or disintegration of the smooth cartilage that covers the bones of the shoulder. These cartilage surfaces allow the bones to move smoothly against one another in a healthy shoulder. When these cartilage surfaces are lost, the bones come into direct touch with one another, generating friction and causing them to roughen and injure one another. Bone-on-bone movement can be very painful.
The injured elements of the shoulder are removed and replaced with artificial components termed prostheses during shoulder replacement surgery. If nonsurgical therapy such as drugs and activity adjustments are no longer effective in reducing discomfort, shoulder joint replacement surgery may be an option. Joint replacement surgery is a pain-relieving operation that is both safe and effective.
Conditions that can be treated by Shoulder Replacement ?
- Rheumatoid Arthritis
- Post Traumatic Arthritis
- Severe Comminated fractures of Proximal Humerus
- Rotator Cuff tear Arthropathy
Shoulder Replacement Options in Ahmedabad
The typical total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket.
These components come in various sizes. They may be either cemented or “press fit” into the bone. If the bone is of good quality, your surgeon may choose to use a non-cemented (press-fit) humeral component. If the bone is soft, the humeral component may be implanted with bone cement. In most cases, an all-plastic glenoid (socket) component is implanted with bone cement.
A reverse shoulder replacement is one in which the ball and socket positions are reversed: a metal ball implant is placed where the patient's natural socket was, and a plastic socket implant is placed on the humeral head's head.
This reverse design is more stable because it does not rely on tendons to keep it in place. The deltoid muscle, rather than the rotator cuff tendon, controls its motion. This makes it an excellent alternative when a damaged shoulder requires new surfaces but lacks healthy soft tissues to support stability and movement. Patients with shoulder arthritis and a serious rotator cuff tear are often candidates for this procedure.
Depending on your shoulder's condition, your surgeon may merely replace the ball. Hemiarthroplasty is the name for this treatment.
When the humeral head is severely shattered but the socket is normal, some surgeons propose hemiarthroplasty. The following are some more reasons for a hemiarthroplasty:
- Arthritis that only involves the head of the humerus with a glenoid that has a healthy and intact cartilage surface
- Shoulders with severely weakened bone in the glenoid
- Some shoulders with severely torn rotator cuff tendons and arthritis
Resurfacing hemiarthroplasty involves replacing just the joint surface of the humeral head with a cap-like prosthesis without a stem. With its bone preserving advantage, it offers those with arthritis of the shoulder an alternative to the standard stemmed shoulder replacement.
Resurfacing hemiarthroplasty may be an option for you if:
- The glenoid still has an intact cartilage surface
- There has been no fresh fracture of the humeral neck or head
- There is a desire to preserve humeral bone
Candidates for Surgery
- A completely torn rotator cuff that cannot be repaired
- Cuff tear arthropathy
- A previous shoulder replacement that was unsuccessful
- Severe shoulder pain and difficulty lifting your arm away from your side or over your head
- A complex fracture of the shoulder joint
- A chronic shoulder dislocation
- A tumour of the shoulder joint
- Tried other treatments, such as rest, medications, cortisone injections, and physical therapy, that have not relieved shoulder pain
This procedure to replace your shoulder joint with an artificial device usually takes about 2 hours.
Your surgeon will make an incision either on the front or the top of your shoulder. He or she will remove the damaged bone and then position the new components to restore function to your shoulder.
After surgery, your medical team will give you several doses of antibiotics to reduce your risk for infection, and pain medication to keep you comfortable. Most patients are able to eat solid food and get out of bed the day after surgery. You will most likely be able to go home on the second or third day after surgery.
Your arm will be in a sling when you leave the hospital. To improve your mobility and endurance, your surgeon may recommend that you practise modest range-of-motion exercises. To strengthen your shoulder and improve flexibility, a formal physical therapy programme may be prescribed.
Within a few weeks of surgery, you should be able to eat, dress, and groom yourself.
In order to keep an eye on your shoulder, your surgeon may want you to return for office visits and x-rays.
Do’s and Dont’s After Surgery
- Do follow the home exercise program prescribed by your doctor.
- Do avoid extreme arm positions, such as behind your body or your arm straight out to the side for the first 6 weeks.
- Don’t overdo it.
- Don’t lift anything heavier than 5 lbs. for the first 6 weeks after surgery.
- Don’t push yourself up out of a chair or bed, as this requires forceful muscle contractions.
- Don’t participate in repetitive heavy lifting after shoulder replacement.