For people going through with chronic arthritis of the shoulder who have not attained pain relief from non-surgical treatments, or who have had a serious fracture, a total shoulder replacement is usually an option. The surgeon substitutes the injured or arthritic joint surfaces with an extremely-polished metal ball attached to a stem and a plastic socket. In cases where the ball is seriously damaged and the socket is normal, the surgeon may substitute only the ball.
Along with any joint replacement surgery, a recuperation program that includes physical therapy and prescribed exercises are the key to a successful recovery.
In certain cases, where the rotator cuff tendons are seriously deteriorated or torn beyond restoration possibilities and the patient has a drastic loss of mobility and chronic pain, a reverse shoulder replacement may be the right choice. A reverse shoulder replacement works well with a person has a rotator cuff arthropathy. This method depends on the deltoid muscle as opposed to the rotator cuff to power and position the shoulder.
Damage to the shoulder joint can lead to aging as well as degenerative changes, also an injury. Arthroplasty (joint replacement – typically with prosthesis) is recommended for the following reasons :
1. Osteoarthritis – a degenerative joint disease is usually triggered by age-related variations in joint health, but may arise in young patients with any kind of metabolic disorders, also a result of continued excessive use.
2. Complications linked to rheumatoid arthritis
3. Complications arising out of post-traumatic arthritis
4. Injury to the ligamentous apparatus
5. Avascular necrosis of the humeral head – advanced due to circulatory conditions linked to bone thrombosis, embolism, vasculopathy, fractures, and specific blood disorders
6. Intra-articular fractures along with irreversible damage to the bones of the head and articular surfaces
7. Penetrating injuries in the joint
8. Complications from earlier surgical intervention on the shoulder joint
The Bone and Joint Orthopedic Clinic at Koramangala, Bangalore offers several modern techniques for shoulder joint arthroplasty, namely :
1. Total Shoulder Replacement– It is the Total replacement of all the joint structures. It uses high-strength artificial implants, reinstating joint function if there is any serious injury in conjunction with injury to joint’s articular surfaces and cartilage.
2. Replacement of humeral head : In contrast to Total replacement of the shoulder joint, this technique replaces only the humeral head, while retaining structures of the glenoid cavity. This procedure is recommended for the patients with localized alteration of the humeral head, with due process caused by blood circulation related conditions
3. Replacement of articular surface of the humeral head – When an injury is restricted to the articular surface of the humeral head, it is probably to preserve key anatomical structures from this technique while sustaining the cartilage of the glenoid cavity.
4. Reverse Total Shoulder Replacement – This technique is performed in patients with the significant amount of structural abnormalities of the joint, distressing not only the joint surfaces but also upsetting muscles and ligaments. This technique converses the joint’s ball and socket mechanisms, letting the patient regain full range of motion with shoulder deltoid muscle.
Shoulder joint replacement operation is conducted post detailed examination of patients and treatment are recommended depending on their age, the extent of functional impairment, patient activity-level, and preferences.
By using an arthroscope not so widely used procedures such as nerve release, fracture restoration, and cyst excision may also be done. Some operating techniques, such as shoulder replacement, still require open surgery with more wide-ranging incisions.
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