Shoulder Replacement in India

The shoulder joint is a ball and socket type of joint. Shoulder replacement surgery, also known as total shoulder arthroplasty, involves replacing the fractured ends of the upper arm bone (humerus) and, in most cases, the shoulder bone (scapula) with artificial implants to relieve pain and restore range of motion.

In individuals with end-stage shoulder arthritis, shoulder replacement is a highly beneficial operation for reducing pain and restoring mobility. The operation relieves discomfort and aids in the restoration of shoulder motion, strength, and function.

Even though shoulder joint replacement is less prevalent than knee or hip replacement, it is just as effective in relieving joint discomfort.

In the 1950s, the first shoulder replacement surgery was conducted in the United States to address serious shoulder fractures. Over time, shoulder joint replacement has grown to be used for a variety of additional painful shoulder disorders, such as various forms of arthritis.

According to the Agency for Healthcare Research and Quality, about 70,000 people in the United States receive shoulder replacement surgery each year. In comparison, almost 900,000 Americans get knee and hip replacement surgery each year.

Indications of Shoulder Replacement:

• Shoulder ache that prevents you from doing things you want to do every day
• You have moderate to severe pain even while taking rest
• Reduction in mobility and/or tiredness.
• There has been no significant improvement with various treatments such as anti-inflammatory medications, cortisone injections, or physical therapy.

Causes of Shoulder Pain

• Osteoarthritis– This type of arthritis is the “Wear and tear” that comes with age. The cartilage that covers the ends of these bones falls away in persons 50 years and older, which can lead to bone grinding against bone and severe bone spurs.
• Rheumatoid Arthritis– The connective tissue thickens and becomes inflammatory, causing cartilage degradation and eventually causing bone loss, discomfort, and stiffness.
• Post-traumatic Arthritis– after a severe shoulder injury
• Rotator Cuff Tear Arthropathy
• Avascular Necrosis– happens when the blood supply to the bone is interrupted
• Severe Fractures– A serious fracture of the shoulder is another frequent reason individuals have shoulder replacements.
• Failed Previous Shoulder Replacement Surgery

Types of Shoulder Replacement

Shoulder replacements are of various types. Before making any recommendations, your surgeon will carefully assess your circumstances. They’ll talk to you about which sort of replacement is best for you. Do not hesitate to inquire about the type of implant that will be utilized in your case, as well as why that particular option is the best option for you.

1) Total Shoulder Replacement:

The most standard total shoulder replacement involves replacing the arthritic joint surfaces using a metal ball attached to a stem, and a plastic socket.

These components are available in a variety of sizes. They can be glued or pressed into place in the bone. Your surgeon may opt for a non-cemented (press-fit) humeral component if the bone is of acceptable quality.

The humeral component may be implanted with bone cement if the bone is soft. In most situations, bone cement is used to implant an all-plastic glenoid (socket) component.

Patients with bone-on-bone osteoarthritis and healthy rotator cuff tendons are usually good candidates for total shoulder replacement.

2) Stemmed Hemiarthroplasty:

Depending on your shoulder’s condition, the surgeon may merely replace the ball. Hemiarthroplasty is the name for this treatment.

The surgeon replaces the head of the humerus with a metal ball and stem, identical to the component used in a total shoulder replacement, in a typical hemiarthroplasty. A stemmed hemiarthroplasty is the term for this procedure.

When the humeral head is severely shattered but the socket is normal, some surgeons propose hemiarthroplasty. The following are some more reasons for a hemiarthroplasty:

• Arthritis that involves only the head of the humerus, with a glenoid that has a healthy and intact cartilage surface
• Shoulders with severely weakened bone in the glenoid
• Some shoulders with severely torn rotator cuff tendons and arthritis

In some cases, doctors choose between a total shoulder replacement and a hemiarthroplasty in the operating room during surgery.

Total shoulder arthroplasty relieves pain better than hemiarthroplasty in patients with osteoarthritis, according to studies.

3) Resurfacing Hemiarthroplasty:

Resurfacing hemiarthroplasty includes replacing only the humeral head’s joint surface with a cap-like prosthesis that does not have a stem. It provides a bone-preserving alternative to the traditional stemmed shoulder replacement for patients with arthritis of the shoulder. It is recommended in patients where:

• The glenoid still has an intact cartilage surface
• There has been no fresh fracture of the humeral neck or head
• There is a desire to preserve humeral bone

Resurfacing hemiarthroplasty eliminates the hazards of component wear and loosening that might arise with traditional complete shoulder replacements in patients who are young or very active. Resurfacing hemiarthroplasty may be easier to convert to total shoulder replacement later, if necessary, because of its more conservative nature.

4) Reverse Total Shoulder Replacement:

Reverse total shoulder replacement is a different form of shoulder replacement. People who need a reverse complete shoulder replacement have:

• Completely torn rotator cuffs with severe arm weakness
• The effects of severe arthritis and rotator cuff tearing (cuff tear arthropathy)
• Had a previous shoulder replacement that failed

Even with a traditional total shoulder replacement, these people may have pain. They may also find it difficult to raise their arm above a 90-degree angle. It can be extremely debilitating to be unable to move your arm away from your side.

The socket and metal ball are switched in a reverse complete shoulder replacement: The shoulder bone is linked to a metal ball, while the upper arm bone is attached to a plastic socket. This permits the patient to elevate the arm using the deltoid muscle rather than the damaged rotator cuff.

When is Shoulder Replacement Needed?

An older patient with severe pain from degenerative shoulder arthritis – pain that hasn’t responded to conservative treatment but hasn’t substantially reduced the patient’s range of motion in the shoulder – is the best candidate for total shoulder replacement surgery.

Patients with bone-on-bone osteoarthritis and healthy rotator cuff tendons are usually good candidates for total shoulder replacement.

How is Shoulder Replacement Done?

What Results Can I Expect from Shoulder Replacement?

The outcomes of shoulder replacement surgery are highly encouraging. Approximately 95% of people who have shoulder replacements are pain-free. Shoulder replacement can help you live a better life by reducing joint pain, increasing your range of motion, and improving your quality of life. It may take a few months before you realize all of the benefits of the procedure.

What is the Recovery after Shoulder Replacement like?

Patients usually need eight weeks or longer to recover. A patient may not be able to conduct heavy labor or intensive strength exercises for several months. The patient can begin unrestricted, active use of the arm and shoulder in 6-8 weeks. Throughout physical treatment, mobility improves. In two to three weeks, one can return to work.