Diseases such as osteoarthritis, arthritis or suffering a fracture in one of our bones can cause us not to regain full mobility. Surgery to apply a prosthesis may be one of the best options. In the following article, Dr. Valdés Casas explains what shoulder prosthesis surgery consists of and for which patients it is intended.
For which patients is the implantation of a shoulder prosthesis recommended?
When the patient does not improve with conservative treatment and does not accept the pain and limitations caused by his shoulder disease, whether due to osteoarthritis, arthritis, a sequel of a fracture or an irreparable tendon rupture. The goal is to eliminate pain and restore mobility.
What does the operation for the placement of a shoulder prosthesis consist of?
In this procedure we replace the damaged joint surfaces with artificial prosthetic components. If the tendons of the shoulder are damaged, special prostheses that do not require tendons for their function will be necessary.
What types of prostheses exist?
There are different models of prostheses that are used depending on the existing disease and the age of the patient.
– In a patient with advanced osteoarthritis causing severe pain with loss of joint function and with tendons in good condition, the surgical indication will be the placement of a total anatomical shoulder prosthesis, of the classic type, replacing the two articular surfaces.
– In a patient with joint destruction secondary to a massive rotator cuff tear, we will recommend the placement of an inverted shoulder prosthesis. In this type of prosthesis, unlike conventional prostheses, the spherical part is implanted in the scapula and the socket in the humerus.
– For young patients with a humeral bone in good condition we have the new prostheses without humeral stem, less aggressive as they do not violate the humeral canal. They can be of the classic anatomical type, the inverted type for patients with very damaged tendons or hemiarthroplasty in which the humeral part is simply replaced.
What is the postoperative period like?
In order to significantly reduce postoperative pain, the operation is performed, in addition to general anesthesia, with brachial plexus anesthesia, through a small injection in the root of the arm is called interscalene block. The patient waking up from general anesthesia has no pain because the arm is anesthetized. The shoulder is slowly waking up and the nursing staff is administering the necessary analgesics to have a postoperative period as comfortable as possible.
Are the results of shoulder prostheses good?
The results are very good, similar to those of prostheses of other joints such as the hip or knee. The current rate of complications with current techniques is very low.
Patients recover very good function after a few weeks with the arm immobilized and a well-conducted rehabilitation program. The surgeon’s experience, a correct selection of the type of prosthesis as well as a good collaboration of the patient are fundamental.