Today individuals have the option of considering joint replacement when osteo arthritis or trauma has damaged the joint to the point where movement becomes unbearably painful. Shoulder replacement surgery may be considered if pain keeps an individual from activities they enjoy or makes daily living activities very difficult.
The shoulder joint is considered one of the more complex joints in the body. There are three bones which form the joint and are held together by tendons and ligaments. The scapula, clavicle and humorous joined together at the shoulder to provide 360° motion for the upper arm. The joint is unique because the ball in the upper arm is two times larger than the socket in the shoulder blade. This means that the joint is highly mobile and gives individuals a greater range of motion but it also means that there is an extensive number of ligaments and muscles necessary to keep the joint together.
In most cases joint replacement or resurfacing will be considered because of arthritis and the damaging changes to the joint surfaces. The symptoms of osteo arthritis of the shoulder are pain and reduced movement. Most individuals report that this pain is a severe in nature and can make it very difficult for patients to sleep. Because the joint surfaces have begun to degenerate certain movements may also cause a grinding sensation or at catching sensation as the bone moves against bone. While there may be swelling it will be difficult to see it because there is so much muscle which covers the shoulder joint.
Diagnosing osteo arthritis of the shoulder will include a complete medical history by your healthcare practitioner followed by a thorough physical examination. Your healthcare practitioner may attempt to reproduce the pain or the catching with certain movements while simultaneously holding their hand over the shoulder joint to palpate any excessive movement and the shoulder. X-rays may show a degree of change in the bones and any wear and tear present and an MRI or arthrogram may be used to confirm the diagnosis.
During an arthrogram special dye is injected into the shoulder joint and x-rays are taken to determine the path of the dye. An MRI can be used to look at the rotator cuff tendons to determine whether they are torn. This is a special test where magnetic waves are used to create pictures which look like slices of the body. This information is fed back to a computer which helps to pull the information together for the radiologist.
When considering joint replacement individuals actually have two different options. The first option is joint resurfacing of the humoral head. This is a surgical procedure that allows the individual to retain more of their natural tissue by replacing only the diseased part of the joint instead of the entire shoulder. This gradual approach may mean that the patient has an option for total joint replacement later if it becomes necessary.
The Resurfacing Humoral Head Implant is an option for patients who are younger and more active and who may otherwise postpone surgery because of the limitations involved with a total shoulder joint replacement. Patients who have arthritis, or rheumatoid arthritis or fractures of the humoral head are all candidates for this implant. During this procedure the implant is fitted onto the top of the humoral bone which preserves most of the patient’s own tissue.
This resurfacing procedure will give pain relief at earlier stages of joint disease while still allowing individuals to consider a total replacement later. This is a conservative approach for younger patients because it replaces only the damaged tissue and allows for greater range of motion. Candidates for resurfacing products may have arthritic damage and humoral head fractures but not rotator cuff tears. These implants are not intended for use in people who have local infections or have poor bone quality.
If the total shoulder replacement has been chosen physicians actually have several options which they can consider in order to improve the functionality of the joint and decrease the pain for the individual. Total shoulder joint replacements will also be considered for individuals who have rotator cuff tears or massive shoulder fractures as well as those who have had damage from osteoarthritis or a fractured humoral head.
Physicians today have a greater range of options to offer patients who suffer from debilitating pain in their shoulder joints. These options allow patients to return to their previous lifestyle often without pain.
Beth Israel Deaconess Medical Center: Sports Medicine and Shoulder Surgery
American Academy of Orthopedic Surgeons: Shoulder Joint Replacement
University of California: Recovering from Shoulder Replacement Surgery
MedlinePlus: SHoulder Replacement
Hospital for Special Surgery: Shoulder Replacement Surgery
University of maryland Medical Center: Reverse Shoulder Replacement Surgery