Reverse shoulder arthroplasty for complex shoulder osteoarthritis

Reverse shoulder arthroplasty has been used more frequently in patients with complex shoulder arthritis. This procedure is designed for patients who have severe arthritis and rotator cuff damage that has led to significant pain, weakness, and limited range of motion in the shoulder joint.

In a healthy shoulder joint, the ball-shaped end of the upper arm bone (humerus) fits into a shallow socket in the shoulder blade (scapula). The rotator cuff muscles and tendons hold the joint together and allow for a wide range of motion. In a reverse shoulder arthroplasty, the traditional ball-and-socket joint is replaced with a prosthetic device that reverses the position of the ball and socket components.

This reversed configuration of the joint allows the deltoid muscle to take over the function of the damaged rotator cuff muscles and tendons. This can provide significant pain relief and improve the patient’s ability to perform daily activities.

The procedure is performed under general anesthesia, and the surgeon makes an incision over the shoulder joint. The damaged bone and tissue are removed, and the prosthetic components are placed in the shoulder joint. The procedure typically takes two to three hours, and patients will need to stay in the hospital for a few days to monitor their recovery.

After the procedure, patients will need to undergo physical therapy to regain strength and range of motion in the shoulder joint. The length of time for recovery varies depending on the severity of the condition and the extent of the surgery.

Reverse shoulder arthroplasty is a safe and effective option for patients with complex shoulder arthritis who have not responded to non-surgical treatments such as physical therapy, NSAIDs, and corticosteroid injections.

If you are experiencing severe pain, weakness, and limited range of motion in your shoulder joint due to complex shoulder arthritis, I encourage you to reach out to our office or click here to discuss nonsurgical and surgical options.

Andrew

Total shoulder vs reverse shoulder replacement

As reverse shoulder replacements become more and more common, patients routinely come in asking about the difference between it and a standard total shoulder replacement. Here goes my explanation:

Anatomic Total Shoulder Arthroplasty:

An anatomic total shoulder arthroplasty, also known as a traditional shoulder replacement, involves replacing the ball-and-socket joint of the shoulder with a metal ball and a plastic socket. This procedure is typically performed when the patient has arthritis of the shoulder joint and has intact rotator cuff muscles.

During the procedure, the surgeon removes the damaged parts of the shoulder joint and replaces them with the artificial joint. The new joint is designed to replicate the natural movement of the shoulder, allowing the patient to regain a significant amount of mobility and function.

Reverse Total Shoulder Arthroplasty:

A reverse total shoulder arthroplasty, on the other hand, is a more recent innovation that was designed for patients with a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis. In these patients, the rotator cuff muscles are not functioning properly and cannot support the joint.

During a reverse shoulder replacement, the surgeon reverses the position of the ball and socket joint. This means that the ball is placed on the socket side of the joint and the socket is placed on the ball side of the joint. This changes the mechanics of the joint and allows the deltoid muscle to take over as the main muscle that powers the shoulder.

The purpose of the reverse shoulder replacement is to restore the patient's ability to lift the arm and perform activities of daily living. However, the range of motion may not be as good as with a traditional shoulder replacement.

In summary, anatomic total shoulder arthroplasty is best for patients who have arthritis of the shoulder joint and have intact rotator cuff muscles. A reverse total shoulder arthroplasty is best for patients who have a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis or significant deformity. Both procedures can help improve the patient's quality of life and restore function to the shoulder joint, but it is important to consult with your surgeon to determine which procedure is right for you.

As always, please feel free to contact my office with any questions.

Andrew

What are the symptoms of shoulder arthritis?

This is part 2 of our discussion on shoulder arthritis. Previous posts include:

What is shoulder arthritis?

Pain is by far the most common symptom of arthritis of the shoulder.  This pain is normally aggravated by activity and worsens over time.  The pain may be felt as a deep ache or may be centered in the back of the shoulder.  This pain also normally intensifies with changes in the weather.  Night pain is also incredibly common with most shoulder problems.

Decreased range-of-motion is also very common with shoulder arthritis.  This may be secondary to pain or may be from a tight shoulder capsule or bone spurs.

Please stay tuned for more posts on the diagnosis and treatment of shoulder arthritis.

What is shoulder arthritis?

This post is part 1 of my posts on shoulder arthritis.

Arthritis is the abnormal wearing down of cartilage in the joint.  Cartilage is the smooth, protective layer that acts like a cap at the end of bones in joints.  The complete cause of the most common type of arthritis, osteoarthritis, is still unknown.  We believe that it is a combination of genetic and activity related factors.  The other type of arthritis is called inflammatory arthritis and may include rheumatoid arthritis.  

Arthritis in the shoulder is normally between the ball of the humerus and the socket of the shoulder blade.  Patients can also get arthritis between the shoulder blade and the collar bone, called AC joint arthritis.

Stay tuned for my next posts about the diagnosis and treatment of shoulder arthritis.

Shoulder arthritis

Shoulder Replacements detailed and their benefits #Health

When people typically think of a joint replacement they will think of a knee or hip.  However, shoulder replacements, though less common, can have a resounding effect on the quality of life of the individual.

Shoulder joint replacement is a safe, effective procedure to help with painful conditions of the shoulder that cannot be adequately managed with medications or therapy.

Why are shoulder replacement procedures performed?

Your shoulder is a ball-and-socket joint that’s comprised of three bones: the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). The ball, or head, of your upper arm fits into a shallow socket in your shoulder blade.  When your shoulder is functioning properly, a thin, smooth tissue called synovial membrane makes fluid that lubricates the cartilage, allowing your shoulder to move smoothly and easily without much friction. The muscles and tendons that surround the shoulder provide support, and all these structures working together allow the shoulder to rotate through a greater range of motion than any other joint in the body.

Conditions such as arthritis can cause joints to lose their cartilage covering, and when you move, bone will move on bone without adequate protection. The result can be very painful, and you may experience a limited range of motion that hampers your ability to accomplish your daily activities.

What are the different types of shoulder replacement procedures?

Shoulder replacement surgery replaces the ball and sometimes the socket with man-made parts. Often the ball is replaced with metal and the socket is replaced with plastic. The components can be held in place with cement, or they can be made of material that lets new bone grow into the joint component over time, holding it in place.

There are several types of shoulder replacement surgery:

Hemiarthroplasty – the ball part of the head is replaced with an artificial joint that has a stem to extend into the shaft part of the bone. It’s usually used for fractures but is also often used for shoulders affected by arthritis.

Shoulder resurfacing – a different type of hemiarthroplasty that requires the removal of less bone. Instead of removing the ball part of the joint, a metal cap is simply placed over it.

Total arthroplasty – this replaces both the ball and socket and is usually used for specific types of arthritis. Your doctor will take into consideration your age, how badly worn the natural joint is, and the condition of the tendons around the joint. A total arthroplasty will sometimes be performed using a resurfacing component.

Reverse shoulder arthroplasty – artificial components are fitted in reverse, with the socket to the upper arm bone and the ball to the shoulder blade. It’s usually only performed on patients with severe arthritis and extremely poor rotator cuff tendons around the joint. It’s sometimes be used if a patient has both a severe joint fracture and poor tendon function.

I, as your surgeon, will determine the location, type, and extent of your shoulder problem before recommending the type of joint replacement that would be most suitable in your particular case.

Are you a candidate for shoulder replacement surgery?

The decision to have shoulder replacement surgery should be made in cooperation with you, your family, your family doctor, and your orthopedic surgeon

Why does my shoulder hurt? #Health #Seattle

You can experience pain in your shoulder for a variety of reasons, many of which are issues that are minor and shouldn’t worry you.   Your shoulder joint is covered in a tissue that is tough and lubricates the joint articulation (where the bones in your shoulder meet) called cartilage.   When your cartilage is healthy and functioning properly, you are able to experience full range of motion with little to no pain.  However, as we age or when we experience an injury in the shoulder, the cartilage can wear thin or become damaged.  This damage can cause pain and stiffness which will limit your range of motion in the shoulder.    When you begin to experience pain or stiffness in your shoulder, try simple pain relief techniques like stretching, ice, and/or heat.   If pain persists, it may be time to review your options with a shoulder specialist.