Shoulder Replacement

Total shoulder replacement, also known as total shoulder arthroplasty (TSA), is a tremendously successful procedure for treating the severe pain and stiffness that often result at the end stage of various forms of arthritis or degenerative joint disease of the shoulder joint. The primary goal of shoulder replacement surgery is pain relief, with a secondary benefit of restoring motion, strength, function, and assisting with returning patients to an activity level as near to normal as possible. The actual surgery involves replacing the damaged humeral head with a metal ball, and putting a new smooth plastic surface on the glenoid.
WHEN YOUR SURGEON WILL RECOMMEND SHOULDER REPLACEMENT:

• Severe pain while performing activities
• Insufficient pain relief from non-surgical treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, and steroid injections.
• Loss of motion.
• Pain that affects sleep.
• Inability to lift the affected arm to perform daily tasks, such as reaching high shelves.
• Stiffness and pain with overhead movement.

ADVANTAGES OF SHOULDER REPLACEMENT:

• Much less pain after surgery
• Able to do many of their daily activities more easily.
• The surgery will allow you to do more of your normal activities without pain.
• You can resume activities such as golfing, riding a bike, swimming, walking for exercise etc.

CAUSES FOR SHOULDER REPLACEMENT

Osteoarthritis – The shoulder is made up of two joints, the acromioclavicular (AC) joint and the glenohumeral joint. The AC joint is the point where the collarbone, or clavicle, meets the acromion, which is the tip of the shoulder blade. The glenohumeral joint is the point where the top of the arm bone, or humerus, meets the shoulder blade, or scapula.

Rheumatoid arthritis – This disease of the shoulder occurs as the result of an autoimmune reaction that targets the synovial lining of the shoulder joint. The condition causes significant pain and inflammation, and typically occurs symmetrically on each side of the body.

Post Traumatic Arthritis – Since shoulder injuries are commonly due to the shoulder joint’s instability, injuries such as shoulder fractures and shoulder dislocations may eventually lead to PA. Sporting injuries and other accidents can also cause this condition.

• Avascular Arthritis – A condition called avascular necrosis (AVN) can result in shoulder arthritis by destroying the joint tissues in your shoulder. It’s caused when blood cannot reach your humerus bone (the long bone of the upper arm). This can cause cells in your shoulder bone to die.

Rotator Cuff Tear Arthropathy – Your shoulder contains a rotator cuff, which connects the shoulder blade with the top of your arm through a collection of tendons and muscles. Injuries to the rotator cuff are common and can lead to a form of shoulder arthritis called rotator cuff tear arthropathy.

TYPES OF SHOULDER REPLACEMENT SURGERIES AVAILABLE IN INDIA:

Total shoulder replacement/Traditional Shoulder Arthroplasty This surgery replaces the original ball-and-socket surfaces of the shoulder with similarly shaped prosthetics. Total shoulder replacement is considered the most reliable surgical option for relieving debilitating shoulder arthritis, but it is not appropriate for people who want to remain very active or have damaged rotator cuff muscles.

Reverse shoulder replacement – During reverse shoulder replacement the surgeon switches, or reverses, the positions of the shoulder joint’s ball and socket. The ball at the top of the humerus (upper arm bone) is replaced with a socket-shaped prosthetic, while the shoulder’s natural socket is fitted with a prosthetic ball. This surgery is an option for people whose damaged rotator cuffs make them ineligible for traditional shoulder replacement. It changes the center of rotation of the joint, enabling other muscles to compensate for a lack of rotator cuff function.

Partial shoulder replacement – During a partial shoulder replacement, or shoulder hemiarthroplasty, the arm’s humeral head is removed and replaced with a prosthetic ball but the natural socket, or glenoid bone, is kept.