A shoulder replacement is a less common procedure unlike a knee replacement or a hip replacement procedure. The shoulder is a ball-and-socket joint which has a wider range of motion than any other joint in the human body. Shoulder joint gives strength and range of motion to the arm.
The shoulder joint is made of a rounded end of the upper arm bone (head of the humerus) which glides against the small socket (glenoid) in the shoulder blade (scapula). Muscles and tendons, such as the rotator cuff, help hold the joint in place. The surfaces of the joints are normally covered with smooth cartilage.
Over a period of time, the continuous wear and tear of the joint may lead to loss of the cartilage and mechanical deterioration of the joint. The result can be pain. You can have a stiff shoulder that grinds or clunks. This can lead to a loss of strength, decreased range of motion in the shoulder and impaired function. This is called Osteoarthritis or wear-and-tear arthritis. Osteoarthritis is a degenerative joint disease and is one of the most common diseases which is treated by a shoulder replacement surgery when all other conservative treatments like medications, physical therapy, activity modification etc. fail.
Osteoarthritis generally affects people above 50 years of age or those people who have a history of shoulder injury.
Your doctor will do a physical examination and take your medical history. After this is done, a series of standard x-rays are taken. This helps to know the condition of the shoulder. An X-ray of the shoulder would show the following.
• Loss of the normal cartilage joint space
• Irregularity in the shape of the bone
• Bone spurs
• Loose pieces of bone and cartilage floating inside the joint
A CT scan and Magnetic Resonance Imaging (MRI) may also be necessary to evaluate bone quality as well as the condition of important surrounding structures such as the rotator cuff tendon
1) Shoulder Arthroscopy
Shoulder arthroscopy is a minimally invasive procedure. It is performed to diagnose and treat many shoulder injuries and diseases without a major cut. This procedure is performed by making small incisions through which a small camera, called an arthroscope is inserted. The doctor sees the joint and the surrounding areas on a computer screen. This helps in examining and performing surgery on the bones and soft tissues in and around the shoulder. Most surgeons prefer arthroscopy instead of open shoulder surgery because an arthroscopic procedure has many benefits. Some of the major advantages of this procedure are:
• Quicker recovery and shorter hospital stay
• Less blood loss
• Less scarring
• Less risk of infection
2) Shoulder Replacement
In a shoulder replacement surgery, the shoulder joint is replaced by an implant or prosthesis. Shoulder replacement involves replacing the humeral head and the glenoid with artificial components. The humeral head replacement is generally made from a metal alloy, while the glenoid component is made from polyethylene plastic. The new components may be anchored by cement or press-fit into place so that the bone grows in around them. In a shoulder replacement surgery a three- to four-inch incision is made along the space between the arm and the collarbone. The procedure lasts about an hour or so. The incision is then closed with staples or stitches.
3) Shoulder Resurfacing
Shoulder resurfacing surgery is an advanced technique is an excellent alternative to total shoulder replacement surgery. This is a bone conserving method since major portion of the bone is not cut unlike a shoulder replacement surgery. Shoulder resurfacing surgery has some advantages like,
• Recovery is faster and better.
• Reconstitution of the joint is much closer to normal after the shoulder resurfacing
• Results of resurfacing are much better in terms of range of movement and function.
• With less bone removal, it is easy to revise if ever required in future.
• Less tissue damage
Rehabilitation and physiotherapy
Well planned rehabilitation and physiotherapy sessions play a very important role in the recovery of the patient. Our network hospitals have a high advanced physiotherapy centres with latest equipments and devices. The staff members are well trained and experienced.