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 part of the shoulder which is replaced
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.
Recovery after the Total Shoulder Replacement
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 atleast a month after that.
Results of total shoulder replacement surgery
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.
Possible complications of total shoulder replacement 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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