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Shoulder Replacement

The shoulder is the most flexible joint in your body. It allows you to place and rotate your arm in many positions.

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SHOULDER REPLACEMENT SURGERY

The shoulder is that the most joint in your body. It permits you to position and rotate your arm in several positions before, above, to the facet, and behind your body. This flexibility conjointly makes your shoulder prone to instability and injury.
Depending on the character of the matter, non-surgical ways of treatment typically square measure suggested before surgery.
However, in some instances, delaying the surgical repair of a shoulder will increase the chance that the matter are tougher to treat later. Early, correct designation and treatment of shoulder issues will create a big distinction within the end of the day.

How the Normal Shoulder Works

The shoulder may be a ball-and-socket joint. It’s created of 3 bones: the higher long bone (humerus), scapula (scapula) and clavicle (clavicle).
The ball at the highest finish of the long bone fits into the little socket (glenoid) of the scapula to create the ball-and-socket joint (glenohumeral joint).
The socket of the glenoid is enclosed by a soft-tissue rim (labrum).
A smooth, sturdy surface (articular cartilage) on the pinnacle of the long bone and a skinny inner lining (synovium) of the joint permits the sleek motion of the ball-and-socket joint.
The higher a part of the scapula (acromion) comes over the ball-and-socket joint. One finish of the clavicle is joined with the scapula by the acromioclavicular (AC) joint. The opposite finish of the clavicle is joined with the os (sternum) by the sternoclavicular joint.
The joint capsule may be a skinny sheet of fibers that surrounds the ball-and-socket joint. The capsule permits a large vary of motion, however, provides stability.
A bodily structure may be a cluster of muscles and tendons that attach your higher arm to your scapula. The bodily structure covers the ball-and-socket joint and joint capsule.
The muscles hooked up to the bodily structure alter you to carry your arm, reach overhead, and participate in activities like throwing or swimming.
A sac-like membrane (bursa) between the bodily structure and also the scapula cushions and helps lubricate the motion between these 2 structures.

Shoulder Problems and Treatments

Bursitis or Tendinitis

Bursitis or tendinitis can occur with overuse from repetitive activities, such as swimming, painting, or weight lifting. These activities cause rubbing or squeezing (impingement) of the rotator cuff under the acromion and in the acromioclavicular joint. Initially, these problems are treated by modifying the activity which causes the symptoms of pain and with a rehabilitation program for the shoulder.

Impingement and Partial Rotator Cuff Tears

Partial thickness rotator cuff tears can be associated with chronic inflammation and the development of spurs on the underside of the acromion or the acromioclavicular joint.

The conservative nonsurgical treatment is modification of activity, light exercise, and, occasionally, a cortisone injection. Nonsurgical treatment is successful in a majority of cases. If it is not successful, surgery often is needed to remove the spurs on the underside of the acromion and to repair the rotator cuff.

Full-Thickness Rotator Cuff Tears

Full-thickness rotator cuff tears are most often the result of impingement, partial thickness rotator cuff tears, heavy lifting, or falls. Nonsurgical treatment with modification of activity is successful in a majority of cases.

If pain continues, surgery may be needed to repair full- thickness rotator cuff tears. Arthroscopic techniques allow shaving of spurs, evaluation of the rotator cuff, and repair of some tears.

Both techniques require extensive rehabilitation to restore the function of the shoulder.

Instability

Instability happens once the top of the higher os longum is forced out of the shoulder socket. This will happen as a result of fast injury or from overuse of the shoulder ligaments.

The two basic styles of shoulder instability square measure subluxations and dislocations. A luxation may be a partial or incomplete dislocation. If the shoulder is partly out of the shoulder socket, it eventually could dislocate. Even a minor injury could push the os longum out of its socket. A dislocation is once the top of the os longum slips out of the shoulder socket. Some patients have chronic instability. Shoulder dislocations could occur repeatedly.

Patients with repeat dislocation typically need surgery. Open surgical repair could need a brief keep within the hospital. Arthroscopic surgical repair is commonly done on AN patient basis. Following either procedure, in-depth rehabilitation, typically together with physiotherapy, is critical for healing.

Fractured Head of the Humerus (Arm Bone), or Proximal Humerus Fracture

A fractured head of the humerus is a common result of falls on an outstretched arm, particularly by older people with osteoporosis. If fragmented or displaced, it may require open surgical repair and possibly replacement with an artificial joint (prosthesis).

Fractured Collarbone and Acromioclavicular Joint Separation

A fractured collarbone and acromioclavicular separation are common injuries of children and others who fall on the side of their shoulder when playing. Most of these injuries are treated non surgically with slings or splints. Severe displaced fractures or acromioclavicular joint separation may require surgical repair.

Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis and rheumatoid arthritis can destroy the shoulder joint and surrounding tissue. They can also cause degeneration and tearing of the capsule or the rotator cuff. Osteoarthritis occurs when the articular surface of the joint wears thin. Rheumatoid arthritis is associated with chronic inflammation of the synovium lining which can produce chemicals that eventually destroy the inner lining of the joint, including the articular surface.

SHOULDER REPLACEMENT (PROCEDURE)

Shoulder replacement is recommended for patients with painful shoulders and limited motion. The treatment options are either replacement of the head of the bone or replacement of the entire socket .

1. ORTHOPAEDIC EVALUATION

The medical science analysis of your shoulder consists of 3 components: A medical record to collect data concerning current complaints; period of symptoms, pain and limitations; injuries; and past treatment with medications or surgery. A physical examination to assess swelling, tenderness, a variety of motion, strength or weakness, instability, and/or deformity of the shoulder. Diagnostic tests, like X-rays dotty the shove varied positions.
Magnetic resonance imaging (MRI) is also useful in assessing soft tissues within the shoulder. X-raying (CT) scan is also accustomed measure the bony components of the shoulder. We are going to review the results of your analysis with you and discuss the simplest treatment.
If surgery is that the most suitable choice, you may be explained the advantages vs potential risks and complications.

2. PREPARING FOR SURGERY

No food or drink after midnight before surgery. Discuss with us what to do about medications taken in the morning. Pre-anaesthetic check up prior to the surgery . Types of Surgical Procedures You may be given the option to have an arthroscopic procedure or an open surgical procedure.

3. ARTHROSCOPY

Arthroscopy allows us to insert a pencil-thin device with a small lens and lighting system into tiny incisions to look inside the joint. The images inside the joint are relayed to a TV monitor, allowing us to make a diagnosis. Other surgical instruments can be inserted to make repairs, based on what is with the arthroscope. Arthroscopy often can be done on an outpatient basis.

4. OPEN SURGERY

Open surgery may be necessary and, in some cases, may be associated with better results than arthroscopy. Open surgery often can be done through small incisions of just a few inches. Recovery and rehabilitation is related to the type of surgery performed inside the shoulder, rather than whether there was an arthroscopic or open surgical procedure.

POST SURGERY

Possible Complications After Surgery

There are always some risks with any surgery, even arthroscopic procedures. These include possible infection, and damage to surrounding nerves and blood vessels. However, modern surgical techniques and close monitoring have significantly minimized the occurrence of these problems.
After surgery, some pain, tenderness, and stiffness are normal. You should be alert for certain signs and symptoms that may suggest the development of complications.
After surgery, some pain, tenderness, and stiffness are normal. You should be alert for certain signs and symptoms that may suggest the development of complications.

Fever after the second day following surgery

Increasing pain or swelling
Redness, warmth, or tenderness which may suggest a wound infection
Unusual bleeding (some surgical wound drainage is normal and, in fact, desirable
Numbness or tingling of the arm or hand
Prevention of Future Problems & Summary

As you can see, the shoulder is extremely complex, with a design that provides maximum mobility and range of motion. Besides big lifting jobs, the shoulder joint is also responsible for getting the hand in the right position for any function. When you realize all the different ways and positions we use our hands every day, it is easy to understand how hard daily life can be when the shoulder isn’t working well.