Most
people know someone with an artificial
hip or knee. Fewer people know anyone
with a shoulder replacement. (Arthroplasty)
Shoulder replacement surgery is an option
for treatment of severe arthritis of
the shoulder joint, but very often people
tolerate their symptoms longer because
the arm is not a weight bearing extremity.
Additionally, many people do not even
know that shoulder replacement is an
option.
Arthritis affects the cartilage of the
joints. The cartilage is worn away and
the protective lining between the bones
is lost, causing painful bone on bone
rubbing. Severe shoulder arthritis is
quite painful, and can cause restriction
of motion. While this may be tolerated
with some medications and lifestyle
adjustments, there may come a time when
surgical treatment is necessary.
What
is a Reverse total shoulder replacement?
Total
shoulder replacement surgery involves
the replacement of the damaged bone
and cartilage with metal and plastic
implants, thus alleviating pain and
restoring mobility.
The shoulder joint is a ball-and-socket
joint, with a very shallow socket.
The ball is the top of the arm bone
(the Humerus), and the socket is part
of the shoulder blade (scapula) called
the glenoid. Stability is maintained
by the ligaments and muscles. This
mechanism allows a vast range of motion
at the shoulder.
During shoulder replacement surgery,
the ball is removed from the top of
the Humerus and replaced with a metal
implant. This is shaped like a half-moon
and attached to a stem inserted down
the center of the arm bone. The socket
portion of the joint is shaved to
remove the cartlidge and replaced
with a plastic socket that is cemented
into the scapula.
Reverse total Shoulder Arthroplasty is performed on select patients with Rotator Cuff tears. In this procedure, the prosthetic ball (glenosphere) is placed on the glenoid and the socket is placed on top of the humerus.
Shoulder replacement surgery takes
about two hours. The incision for
the surgery is along the front of
the shoulder joint, usually about
six inches long. The surgery is most
often done under general anesthesia,
where the patient is put to sleep.
Hospital stays range from one to three
days.
Total rehabilitation from shoulder
replacement surgery usually takes
three to six months, but patients
say it is well worth it. At that juncture,
patients are able to return to most
normal activities and place an emphasis
on strengthening the muscles around
the shoulder and maintaining range
of motion.
As with any surgery, there are risks
involved, although complications are
not frequent. Advances in surgical
techniques and prosthetic innovations
are helping to reduce the occurrence
of these complications. Surgeon experience
is also paramount in reducing complications.
