Shoulder Replacement, an entity unknown to many, has been in existence since decades now. The shoulder joint is made up of two bones. Head of humerus on the one side articulates with glenoid of scapula on the other side. The humeral head rotates in this shallow glenoid with the arm movement. A normal joint has a layer of cartilage in between the bones. This cartilage wears down in osteoarthritis and bone of one side is in direct contact of bone on the other side. This bone to bone movement is a cause of severe pain. The patient comes with complaints of chronic constant shoulder pain which is often bilateral. Best diagnosis is made by a plain radiograph of shoulder. An accessory CT Scan or MRI Scan may be taken to access the bone and soft tissue in details.
The surgery involves replacement of the parts of the shoulder joint with artificial implant. The glenoid is replaced with an artificial socket and humeral head is replaced by a metallic ball ( opposite is true in reverse shoulder replacement). The improvements in the implant designs, which give much better post operative results is one of the key development in this area. The doctor can predict the possible outcome and boost patient’s confidence. This surgery has been boon for those suffering from constant chronic shoulder pain because of changes in the bone. Though this surgery is considered as a last resort surgery, best results are achieved when the pain starts affecting regular lifestyle of an individual and all conservative options fails.
There are two types shoulder replacements. One is Anatomical Shoulder Replacement and the next is Reverse Shoulder Replacement.
ANATOMICAL SHOULDER REPLACEMENT
The shoulder like any other joint of the body undergoes degeneration with age. The bones start rubbing against each other and causes severe pain. The main emphasis is that, the muscle surrounding the shoulder joint, the rotator cuff muscle, is functionally normal. In this case we are in a condition similar to knee osteoarthritis and treatment is very similar to knee replacement. Yes, we proceed for anatomical shoulder replacement, in which the bony surface of either side is cut and replaced with a new prosthesis. The patients do very well after surgery.
REVERSE SHOULDER REPLACEMENT
The frequency of reverse shoulder replacement has increased drastically over the last few years. This is due to combined effect of availability of shoulder surgeons as well as increased awareness among public in large. This surgery is done when bones are damaged and in addition, the rotator cuff muscles around the joint is non functional due to any reason. The whole of biomechanics changes here. Normally the humerus has a head and glenoid is shallow socket. We reverse the scenario and fix a ball on glenoid side and socket on humeral side after removing the damaged natural humeral head. The rotator cuff muscle is non functional and deltoid works in this condition to lift the arm.
Considering the great advancements in the field of shoulder surgery, its wise to consult a shoulder surgeon for any kind of shoulder pain.