Shoulder Replacement
The shoulder joint can be replaced by
an artificial shoulder or shoulder replacement for pain caused by arthritis or
when the shoulder is severely fractured or broken. Arthritis is when the
cartilage on the ends of the bones is gone and there is bone rubbing on bone in
the joint. Arthritis can be caused by fractures, rheumatoid disease, torn
rotator cuff tendons or just by wear and tear over time (Figure 1).
The shoulder comprises of the ball and
socket joint. The upper part is shaped like a ball and is called the humeral
head while the socket is smaller and is a part of the shoulder blade called
scaptila. In shoulder replacement surgery the ball is replaced
with a metal ball attached to a stem.
The stem is inserted down the shaft of
the humerus. Sometimes cement is utilized to keep the stem in place (Figure 4).
The socket sometimes is replaced with a plastic piece which is usually fixed to
a groove in the socket with cement. Whether a socket is used or not depends
upon how bad the arthritis is in the shoulder and whether the rotator cuff tendons
are intact.
The Total Shoulder Replacement initially starts
with doses of Morphine at the time of surgery. Then it shifts to taking oral
pain medicines. Antibiotics are given intravenous in order to prevent
infections. This is carried on by physiotherapy which is a physical rehabilitation. Physiotherapy
starts from the next day of the surgery and the patient is supposed to stay in
the hospital for 3-4 days. The physiotherapy continues for at least a month
after that.
Shoulder Replacement Surgery is a successful surgery for extreme pain relief. The
success rate and healing of the shoulder after the shoulder replacement is very
high.
Range of motion and function can be
improved by this surgery and it is a sure remedy for pain relief. How much
motion increases depends upon many factors, such as how long the motion has
been lost and whether the rotator cuff tendons are intact and working.
Most patients are very satisfied with
the results of their surgery.
The complications of the surgery are
small (less than five percent). Infection is a concern but we also take
antibiotics to prevent it. Nerve and artery damage is very little. Dislocation
is a rare condition as the whole joint is taken care of. After ten years
approximately 3 percent of the shoulders are loose, but revision surgery
is rarely needed.
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