Tag Archives: Shoulder Replacement Surgery

Shoulder Replacement Surgery For Younger Patients

By  aenriquez  published  June 4, 2019

Shoulder replacement surgery – called a shoulder arthroplasty – has traditionally been relegated to helping elderly patients who suffer from long-term arthritis that is leading to the deterioration of cartilage and possibly bone structure. However, doctors now see advancements in both material and technique may allow the option to be extended to select younger patients. Let’s see if you are a candidate for this type of operation.

Structure

The shoulder is a ball and socket style joint with a design that is likely not quite what most people imagine. While many envision a ball and socket as a mechanism that includes a socket wrapping almost completely around a ball, the shoulder has a ball that simply rests against a slightly concave structure, held in place by muscles and a series of tendons and ligaments. Picture a round-bottomed cup resting against an almost flat saucer, held there by rubber bands. The saucer doesn’t wrap around the cup, it provides a settling place for it and, under normal conditions, it stays where it is while allowing for a wide range of motions.

There are pros and cons of each procedure, which should be discussed thoroughly with a physician

The joint, however, is not a system in which bone moves against bone. This occurs when debilitating conditions, like arthritis, become advanced. Normally, a shoulder joint includes healthy cartilage that allows for smooth motions.

Conditions Change

Arthritis is a condition marked by painful movement owing to the deterioration of cartilage. This can occur with age, but it can also be accelerated by prolonged athletic activity. As such, some of the more dedicated athletes – because they practice or play a lot – develop arthritis prematurely.

Doctors, however, have traditionally been reluctant to recommend shoulder replacement surgery for someone who is still young. The reasons for this included the expectation that wear and tear of the replacement material, a metal ball and a plastic cup that allows for smooth motion — would eventually wear out, requiring a second operation.

Doctors at the Mayo Clinic now say that carefully selected younger patients could benefit from shoulder replacement surgery. Here are the criteria that doctors should look for when selecting a younger patient for this type of operation:

  • healthy rotator cuff that can hold the new joint in place
  • Healthy socket bone stock (called the glenoid bone)
  • Intact deltoid muscle
  • Persistent pain that does not respond well to conventional treatment
  • A patient motivated to complete physical therapy for post-operative healing and restoration

Discussions

Patients should be aware of the options for a shoulder arthroplasty before selecting the right procedure for them. There are pros and cons of each procedure, which should be discussed thoroughly with a physician.

The options for surgery include a traditional shoulder arthroplasty, a partial shoulder replacement in which just the ball is replaced and a reverse shoulder arthroplasty.

Reverse Arthroplasty

Doctors came to the realization that the ball, which is normally the terminal part of your arm, and the socket, which is on the proximal side, could be reversed. In fact, it is beneficial to reverse the ball and the socket in conditions in which there is a complete rotator cuff tear, which no longer functions well to hold the joint in place.

The gains of a reverse shoulder arthroplasty is better stability when there is little or no functioning soft tissue that can hold the joint together.

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What is the Difference between Reverse Shoulder Replacement and Conventional Shoulder Replacement?

By  aenriquez  published  December 13, 2017

A shoulder replacement is used to replace the shoulder socket with a high-density metal or plastic cup. The upper part of the arm is fitted with a meal ball to allow the shoulder natural function. Two options for replacing a damaged joint is the conventional (traditional) shoulder replacement and the reverse shoulder replacement. Shoulder surgery started in the United States in the mid-1950s, and it was first use for severe shoulder fractures. Around 23,000 Americans have shoulder surgery each year.

 

Shoulder Replacement SurgeryWho Needs Shoulder Replacement Surgery?

Certain conditions and factors increase your risk for shoulder replacement surgery. These include:

  • Osteoarthritis is the most common reason for shoulder replacement surgery. A type of wear-and-tear arthritis, osteoarthritis usually affects older people. Over time, the shoulder joint becomes painful and stiff.
  • A severe shoulder fracture is a common reason for a shoulder replacement procedure. When the head of the upper arm bone is shattered, the blood flow is interrupted.
  • Patients with long-standing rotator cuff tear can develop cuff tear arthropathy.
  • Finally, avascular necrosis leads to lack of blood flow to the shoulder, which can lead to humeral head death.

 

Reverse Shoulder Replacement VS. Conventional Shoulder Replacement

When there is significant damage to the rotator cuff and deterioration of the shoulder’s normal structure, a reverse shoulder replacement is the best option. With this procedure, the ball and socket are positioned in the opposite positions. The metal ball is attached to the shoulder, and the socket component is placed on the upper portion of the humerus (upper arm bone).

With the traditional shoulder replacement, the metal ball is attached to the upper arm bone, and the plastic socket is attached to the shoulder bone. The surgery is highly technical, and each case is treated uniquely. The implants are smoothed using special tools to fit your body, and the surgeon carefully assesses each patient individually.

 

Reverse Shoulder Replacement Rehab

A careful and well-planned rehabilitation program is crucial to the success of shoulder replacement. You are started on gentle physical therapy the day of or after your procedure. You will wear an arm sling for the first several weeks after surgery, but start using the arm in a few days, and then only at night for 4-6 weeks. Most patients are performing activities of daily living (dressing, eating, grooming) around 2 weeks post-surgery.

The physical therapist will meet with you 2-4 times each week to learn exercises for flexibility, function, and strength. You should avoid placing your arm in an extreme position, such as behind your body, for at least 6 weeks. In addition, you cannot do heavy lifting or sports for 8-12 weeks. Be sure to not overuse the joint, which may result in severe motion limitations.

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