Understanding your shoulder
Shoulder replacement surgery in Hyderabad Secunderabad
Your shoulder is made of three bones – upper arm bone, shoulder blade and collar bone. The shoulder joint is also a “ball and socket” joint. The ball from the upper arm bone joins the socket on your shoulder blade. The surfaces are covered with cartilage and is lubricated by tissues to eliminate any friction in your shoulder. All these along with muscles allow the shoulder to work perfectly with grater motion than any other body part.
Causes of shoulder pain and indications of shoulder replacement
Several conditions can cause shoulder pain and disability, and lead patients to consider shoulder joint replacement surgery.
It is an age-related wear-and-tear type of arthritis. The cartilage that cushions the bones of the shoulder softens and wears away. The bones then rub against one another. Over time, the shoulder joint slowly becomes stiff and painful.
Chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed inflammatory arthritis.
This can follow a serious shoulder injury. Fractures of the bones that make up the shoulder or tears of the shoulder tendons or ligaments may damage the articular cartilage over time. This causes shoulder pain and limits shoulder function.
Avascular Necrosis (Osteonecrosis)
Avascular necrosis, or osteonecrosis, is a painful condition that occurs when the blood supply to the bone is disrupted. Because bone cells die without a blood supply, osteonecrosis can ultimately cause destruction of the shoulder joint and lead to arthritis.
A severe fracture of the shoulder is another common reason people have shoulder replacements. When the head of the upper arm bone is shattered, it may be very difficult for a doctor to put the pieces of bone back in place. In this case, a surgeon may recommend a shoulder replacement.
Rotator cuff tear arthropathy
A patient with a very large, long-standing rotator cuff tear may develop cuff tear arthropathy. In this condition, the changes in the shoulder joint due to the rotator cuff tear may lead to arthritis and destruction of the joint cartilage.
What is shoulder replacement surgery ?
Total shoulder arthroplasty or replacement is one of the most successful joint replacement surgeries done. The damaged surfaces come into contact with each other and this causes pain and restriction of movements of the shoulder. The surgery is mainly intended to relieve pain and restore mobility of the shoulder.
Shoulder replacement removes the damaged areas of bone and replaces them with parts made of metal & plastic implants. Shoulder implants can be partial or total and comes in few different shapes and sizes. A surgery can take up to a couple of hours and your stay duration will depend on individual needs, generally less than a day.
Why is shoulder replacement recommended ?
Your orthopaedic surgeon will review the results of your evaluation with you and discuss whether shoulder joint replacement is the best method to relieve your pain and improve your function. Other treatment options including medications, injections, physical therapy, or other types of surgery will also be discussed and considered.
An evaluation with an orthopaedic surgeon consists of several components:
- A medical history. Your orthopaedic surgeon will gather information about your general healt="Shoulder surgery"h and ask you about the extent of your shoulder pain and your ability to function.
- A physical examination. This will assess shoulder motion, stability, and strength.
- X-rays. X-rays help to determine the extent of damage in your shoulder. They can show loss of the normal joint space between bones, flattening or irregularity in the shape of the bone, bone spurs, and loose pieces of cartilage or bone that may be floating inside the joint.
- Other tests. Occasionally, your doctor may order blood tests, a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or a bone scan to determine the condition of the bone and soft tissues of your shoulder.
How is the surgery done?
Total Shoulder Replacement
The standard total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket. They may be either cemented or press fit into the bone. In most cases, an all-plastic glenoid (socket) component is implanted with bone cement.
Depending on the condition of your shoulder, your surgeon may replace only the ball. In a traditional hemiarthroplasty, the surgeon replaces the head of the upper arm bone with a metal ball and stem to achieve movement and a more steady joint
Resurfacing hemiarthroplasty involves replacing just the joint surface of the upper arm head with a cap-like prosthesis without a stem. With its bone-preserving advantage, it offers those with arthritis of the shoulder an alt="Shoulder surgery"ernative to the standard stemmed shoulder replacement.
Reverse Total Shoulder Replacement
Another type of shoulder replacement is called reverse total shoulder replacement. In reverse total shoulder replacement, the socket and metal ball are switched: A metal ball is attached to the shoulder bone, and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.
Post-operative care & recovery
You will need the sling to support and protect your shoulder for the first 2 to 6 weeks after surgery, depending on the complexity of your surgery and your surgeon's preference. Wearing a sling will protect your shoulder after surgery. You will have staples running along your wound or a suture beneath your skin. The staples will be removed several weeks after surgery. A dissolving suture beneath your skin will not require removal.
Avoid soaking the wound in water until it has thoroughly sealed and dried. You may continue to bandage the wound to prevent irritation from clothing.
Exercise is a critical component of home care, particularly during the first few weeks after surgery. Follow your surgeon's home exercise plan to help you regain strength. Most patients are able to perform simple activities such as eating, dressing, and grooming, within 2 weeks after surgery. Some pain with activity and at night is common for several weeks after surgery.
You are not allowed to drive a car for 2 to 6 weeks after surgery.
Here are some common do's and don'ts for when you return home:
- Don't use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.
- Do follow the program of home exercises prescribed for you. You may need to do the exercises 2 to 3 times a day for a month or more.
- Don't overdo it! If your shoulder pain was severe before the surgery, the experience of pain-free motion may lull you into thinking that you can do more than is prescribed. Early overuse of the shoulder may result in severe limitations in motion.
- Don't lift anything heavier than a glass of water for the first 2 to 4 weeks after surgery.
- Do ask for assistance. Your physician may be able to recommend an agency or facility to help if you do not have home support.
- Don't participate in contact sports or do any repetitive heavy lifting after your shoulder replacement.
- Do avoid placing your arm in any extreme position, such as straight out to the side or behind your body for the first 6 weeks after surgery.
Any risks or side effects of the surgery
The potential complications of the shoulder replacement surgery include:
- Nerve damage which can weaken and cause pain and numbness around the area
Reach out to us if you have
- Redness, swelling or warmth around the cut
- Leakage from the cut
- Fever and chills
- Severe knee pain that is not relieved by prescribed painkillers
- Sudden sharp pain and clicking or popping sound in the knee joint
- Loss of control over leg movement
- Loss of leg movement
- Any other surgeries planned ahead
Frequently Asked Questions
1. Is there any other option
to shoulder replacement surgery?
It depends on the condition of the joints and tissues around which can be diagnosed through x-rays and other tests. Medication and pain killers will be tried to relive you of the pain but if it doesn’t subside, shoulder replacement will be the option.
2. Is there any age
restriction for shoulder replacement surgery?
No, age is not a consideration for a shoulder replacement surgery, only the conditions are.
3. Will my lifestyle be
Doctors instructions have to be followed diligently and utmost precautions have to be taken for you to get back to normal pain free lifestyle. There has to be a gradual and persistent progress in physical activities which might take upto 12 months post-surgery.
5. What is the cost of
having a shoulder replacement surgery?
The average cost of shoulder replacement is around 1 lakh & can go upto 2.5 lakhs depending on multiple factors like method of surgery, implants, replacement kind and hospital stay.
6. Will my insurance cover
the cost of the shoulder replacement surgery?
Click here to know more about insurance at Yashoda hospitals.