What are some reasons for having shoulder replacement surgery?

Answer 1

Shoulder replacement surgery is usually conducted when shoulder pain becomes unmanageable using other methods. Shoulder replacement surgery is also conducted when a person has lost funtion of their shoulder.

Answer 2

Definition

Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small incision (cut) in your skin.

Alternative Names

SLAP repair; Acromioplasty; Bankart; Shoulder repair; Shoulder surgery

Description

The rotator cuff is a group of muscles and tendons that cover your shoulder joint. These muscles and tendons hold your arm in your ball and socket shoulder joint, and they help you move your shoulder in different directions. The tendons in the rotator cuff can tear when they are overused or injured.

Most people receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

First, your surgeon will examine your shoulder with the arthroscope. Your surgeon will:

• Insert the arthroscope into your shoulder through a small incision. The arthroscope is connected to a video monitor in the operating room.
• Inspect all the tissues of your shoulder joint and the area above the joint -- the cartilage, bones, tendons, and ligaments.
• Repair any damaged tissues. To do this, your surgeon will make 1 to 3 more small incisions and insert other instruments through them. A tear in a muscle, tendon, or cartilage will be fixed. Damaged tissue may need to be removed.

Your surgeon may do one or more of these procedures during your surgery:

• Rotator cuff repair: The edges of the muscles are brought together. The tendon is attached to the bone with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic. They do not need to be removed after surgery.
• Surgery for impingement syndrome: Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. Your surgeon may also cut a specific ligament, called the coracoacromial ligament, and shave off the under part of a bone. This under part of the bone is called the acromion.
• Surgery for shoulder instability: If you have a torn labrum, the rim of the shoulder joint that is made out of cartilage, your surgeon will repair it. Ligaments that attach to this area will also be repaired. The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.

At the end of the surgery using the arthroscope, your incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.

Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues. Open surgery is a more complicated surgery.

Why the Procedure Is Performed

Arthroscopy may be recommended for these shoulder problems:

• A torn or damaged cartilage ring (labrum) or ligaments
• Shoulder instability, where the shoulder joint is loose and slides around too much or becomes dislocated (slips out of the ball and socket joint)
• A torn or damaged biceps tendon
• A torn rotator cuff
• A bone spur or inflammation around the rotator cuff
• Inflammation or damaged lining of the joint. Often this is caused by an illness, such as rheumatoid Arthritis.
• Arthritis of the end of the clavicle (collarbone)
• Loose tissue need to be removed
• Shoulder impingement syndrome, to make more room for the shoulder to move around

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

The risks for any surgery are:

• Bleeding
• Infection
• Blood clot

Risks of shoulder arthroscopy are:

• Shoulder stiffness
• Failure of the surgery to relieve symptoms
• Failure of the repair to heal
• Weakness of the shoulder
• Injury to a blood vessel or nerve

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
• Ask your doctor which drugs you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your Doctor Who treats you for these conditions.
• Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow down wound and bone healing.
• Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of your surgery:

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take your drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

Recovery can take anywhere from 1 to 6 months. You will probably have to wear a sling for the first week. If you had a lot of repair done, you may have to wear the sling longer.

You may take medicine to control your pain.

When you can return to work or play sports will depend on what your surgery involved. It can range from 1 week to several months.

For many procedures, especially if a repair is performed, physical therapy may help you regain motion and strength in your shoulder. The length of therapy will depend on the repair that was done.

Outlook (Prognosis)

Arthroscopy is an alternative to "open" surgery that completely exposes the shoulder joint. Arthroscopy results in less pain and stiffness, fewer complications, shorter (if any) hospital stays, and faster recovery sometimes.

If you had repair done, your body still needs time to heal after arthroscopic surgery, just as you would need time to recover from open surgery. Because of this, your recovery time may still be long.

Surgery to fix a cartilage tear is usually done to make the shoulder more stable. Many people recover fully, and their shoulder stays stable. But some people may still have shoulder instability after arthroscopic repair.

Using arthroscopy for rotator cuff repairs or tendonitis usually relieves the pain, but you may not regain all of your strength.

References

Phillips BB. Recurrent dislocations. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 45.

Phillips BB. Arthroscopy of the upper extremity. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 49.

Answer 3

Definition

Shoulder replacement is surgery to replace the bones of the shoulder joint with artificial joint parts.

Alternative Names

Total shoulder arthroplasty; Endoprosthetic shoulder replacement; Partial shoulder replacement; Partial shoulder arthroplasty; Replacement - shoulder; Arthroplasty - shoulder

Description

You may receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to help you relax during the operation.

The shoulder is a ball and socket joint. The round end of one bone fits into a cavity, or socket, at the end of another bone. This type of joint allows you to move your arm in most directions.

For total shoulder replacement, the round end of your arm bone will be replaced with an artificial stem that has a rounded metal head. The socket part of your shoulder joint will be replaced with a smooth plastic shell (lining) that will be held in place with a special cement. If only 1 of these 2 bones needs to be replaced, the surgery is called a partial shoulder replacement.

For shoulder joint replacement, your surgeon will make an incision (cut) over your shoulder joint to open up the area. Then your surgeon will:

• Remove the head (top) of your upper arm bone (humerus)
• Cement the new metal head and stem into place
• Smooth the surface of the old socket and cement the new shell in place
• Close your incision with staples or sutures
• Place a dressing (bandage) over your wound

Your surgeon may place a drain in this area to carry out fluid that may build up in the joint. The drain will be removed when you no longer need it.

This surgery usually takes 1 to 3 hours.

Why the Procedure Is Performed

Shoulder replacement surgery is usually done when the joint is badly damaged and there is pain or loss of motion. Causes of damage include:

• Osteoarthritis
• Poor result from a former shoulder surgery
• Rheumatoid arthritis
• Badly broken bone in the arm near the shoulder
• Badly damaged or torn tissues in the shoulder
• Tumor in or around the shoulder

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risk for any surgery are:

• Bleeding
• Blood clot
• Infection

Risks of shoulder replacement surgery are:

• Allergic reaction to the artificial joint
• Blood vessel damage during surgery
• Bone break during surgery
• Nerve damage during surgery
• Dislocation of the artificial joint
• Loosening of the implant over time

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
• Ask your doctor which drugs you should still take on the day of your surgery.
• If you have Diabetes, Heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
• Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow down wound and bone healing.
• Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of your surgery:

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take your drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

You may stay in the hospital for 1 to 3 days after your surgery. While there, you may receive physical therapy to help keep the muscles around your shoulder from getting stiff. Before you go home, the physical therapist will teach you how to move your arm around by using your other (good) arm.

Outlook (Prognosis)

Shoulder replacement surgery relieves pain and stiffness for most people. You should be able to do most of your normal daily activities without much problem. Many people are able to return to sports such as golf, swimming, gardening, Bowling, and others.

Your new shoulder joint will last longer if less stress is placed on it. With normal use, most people's new shoulders last for at least 10 years.

References

Azar FM, Calandruccio JH. Arthroplasty of the shoulder and elbow. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 8.

Goldberg VM, Kraay MJ. Surgical treatment of joint diseases. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 299.

Answer 4

Definition

Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small incision (cut) in your skin.

Alternative Names

SLAP repair; Acromioplasty; Bankart; Shoulder repair; Shoulder surgery

Description

The rotator cuff is a group of muscles and tendons that cover your shoulder joint. These muscles and tendons hold your arm in your ball and socket shoulder joint, and they help you move your shoulder in different directions. The tendons in the rotator cuff can tear when they are overused or injured.

Most people receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

First, your surgeon will examine your shoulder with the arthroscope. Your surgeon will:

• Insert the arthroscope into your shoulder through a small incision. The arthroscope is connected to a video monitor in the operating room.
• Inspect all the tissues of your shoulder joint and the area above the joint -- the cartilage, bones, tendons, and ligaments.
• Repair any damaged tissues. To do this, your surgeon will make 1 to 3 more small incisions and insert other instruments through them. A tear in a muscle, tendon, or cartilage will be fixed. Damaged tissue may need to be removed.

Your surgeon may do one or more of these procedures during your surgery:

• Rotator cuff repair: The edges of the muscles are brought together. The tendon is attached to the bone with sutures. Small rivets (called suture anchors) are often used to help attach the tendon to the bone. The anchors can be made of metal or plastic. They do not need to be removed after surgery.
• Surgery for impingement syndrome: Damaged or inflamed tissue is cleaned out in the area above the shoulder joint itself. Your surgeon may also cut a specific ligament, called the coracoacromial ligament, and shave off the under part of a bone. This under part of the bone is called the acromion. The spur can be a cause of inflammation and pain in your shoulder.
• Surgery for shoulder instability: If you have a torn labrum, the rim of the shoulder joint that is made out of cartilage, your surgeon will repair it. Ligaments that attach to this area will also be repaired. The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.

At the end of the surgery using the arthroscope, your incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.

Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues. Open surgery is a more complicated surgery.

Why the Procedure Is Performed

Arthroscopy may be recommended for these shoulder problems:

• A torn or damaged cartilage ring (labrum) or ligaments
• Shoulder instability, where the shoulder joint is loose and slides around too much or becomes dislocated (slips out of the ball and socket joint)
• A torn or damaged biceps tendon
• A torn rotator cuff
• A bone spur or inflammation around the rotator cuff
• Inflammation or damaged lining of the joint. Often this is caused by an illness, such as rheumatoid arthritis.
• Arthritis of the end of the clavicle (collarbone)
• Loose tissue need to be removed
• Shoulder impingement syndrome, to make more room for the shoulder to move around

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

The risks for any surgery are:

• Bleeding
• Infection
• Blood clot

Risks of shoulder arthroscopy are:

• Shoulder stiffness
• Failure of the surgery to relieve symptoms
• Failure of the repair to heal
• Weakness of the shoulder
• Injury to a blood vessel or nerve

Before the Procedure

Always tell your health care provider what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
• Ask your health care provider which drugs you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
• Tell your health care provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your health care provider or nurse for help. Smoking can slow down wound and bone healing.
• Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of your surgery:

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take your drugs your health care provider told you to take with a small sip of water.
• Your health care provider will tell you when to arrive at the hospital.

After the Procedure

Recovery can take anywhere from 1 to 6 months. You will probably have to wear a sling for the first week. If you had a lot of repair done, you may have to wear the sling longer.

You may take medicine to control your pain.

When you can return to work or play sports will depend on what your surgery involved. It can range from 1 week to several months.

For many procedures, especially if a repair is performed, physical therapy may help you regain motion and strength in your shoulder. The length of therapy will depend on the repair that was done.

Outlook (Prognosis)

Arthroscopy is an alternative to "open" surgery that completely exposes the shoulder joint. Arthroscopy results in less pain and stiffness, fewer complications, shorter (if any) hospital stays, and faster recovery sometimes.

If you had repair done, your body still needs time to heal after arthroscopic surgery, just as you would need time to recover from open surgery. Because of this, your recovery time may still be long.

Surgery to fix a cartilage tear is usually done to make the shoulder more stable. Many people recover fully, and their shoulder stays stable. But some people may still have shoulder instability after arthroscopic repair.

Using arthroscopy for rotator cuff repairs or tendonitis usually relieves the pain, but you may not regain all of your strength.

See also:

• Shoulder surgery - discharge
• Using your shoulder after surgery

References

Elkousy HA, Edwards TB. Shoulder: Development of skills for shoulder surgery. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 17, section Q.

Phillips BB. Recurrent dislocations. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 45.

Phillips BB. Arthroscopy of the upper extremity. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 49.

Reviewed By

Review Date: 06/30/2011

C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery; and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 5

Definition

Shoulder replacement is surgery to replace the bones of the shoulder joint with artificial joint parts.

Alternative Names

Total shoulder arthroplasty; Endoprosthetic shoulder replacement; Partial shoulder replacement; Partial shoulder arthroplasty; Replacement - shoulder; Arthroplasty - shoulder

Description

You will receive anesthesia before this surgery. Two types of anesthesia can be used:

• General anesthesia, which means you will be unconscious and unable to feel pain.
• Regional anesthesia to numb your arm and shoulder area so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to help you relax during the operation.

The shoulder is a ball and socket joint. The round end of the arm bone fits into the opening at the end of the shoulder blade, called the socket. This type of joint allows you to move your arm in most directions.

For total shoulder replacement, the round end of your arm bone will be replaced with an artificial stem that has a rounded metal head. The socket part of your shoulder blade will be replaced with a smooth plastic shell (lining) that will be held in place with a special cement. If only 1 of these 2 bones needs to be replaced, the surgery is called a partial shoulder replacement or a hemiarthroplasty.

For shoulder joint replacement, your surgeon will make an incision (cut) over your shoulder joint to open up the area. Then your surgeon will:

• Remove the head (top) of your upper arm bone (humerus)
• Cement the new metal head and stem into place
• Smooth the surface of the old socket and cement the new one in place
• Close your incision with staples or sutures
• Place a dressing (bandage) over your wound

Your surgeon may place a drain in this area to carry out fluid that may build up in the joint. The drain will be removed when you no longer need it.

This surgery usually takes 1 to 3 hours.

Why the Procedure Is Performed

Shoulder replacement surgery is usually done when you have severe pain in the shoulder area, which limits your ability to move your arm. Causes of shoulder pain include:

• Osteoarthritis
• Poor result from a previous shoulder surgery
• Rheumatoid arthritis
• Badly broken bone in the arm near the shoulder
• Badly damaged or torn tissues in the shoulder
• Tumor in or around the shoulder

Your doctor may not recommend this surgery if you have:

• History of infection, which can spread to the replaced joint
• Severe mental dysfunction
• Unhealthy skin around the shoulder area
• Very weak (rotator cuff) muscles around the shoulder that cannot be fixed during surgery

Risks

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

Risk for any surgery are:

• Bleeding
• Blood clot
• Infection

Risks of shoulder replacement surgery are:

• Allergic reaction to the artificial joint
• Blood vessel damage during surgery
• Bone break during surgery
• Nerve damage during surgery
• Dislocation of the artificial joint
• Loosening of the implant over time

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
• Ask your doctor which drugs you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
• Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow down wound and bone healing.
• Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

On the day of your surgery:

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take your drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

You may stay in the hospital for 1 to 3 days after your surgery. While there, you may receive physical therapy to help keep the muscles around your shoulder from getting stiff. Before you go home, the physical therapist will teach you how to move your arm around by using your other (good) arm.

Outlook (Prognosis)

Shoulder replacement surgery relieves pain and stiffness for most people. You should be able to do most of your normal daily activities without much problem. Many people are able to return to sports such as Golf, swimming, gardening, bowling, and others.

Your new shoulder joint will last longer if less stress is placed on it. With normal use, most people's new shoulders last for at least 10 years.

References

Azar FM, Calandruccio JH. Arthroplasty of the shoulder and elbow. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 8.

Goldberg VM, Kraay MJ. Surgical treatment of joint diseases. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 299.

Izquierdo R, Voloshin I, Edwards S, et al. American Academy of Orthopedic Surgeons. Treatment of glenohumeral osteoarthritis. J Am Acad Orthop Surg. 2010 Jun;18(6):375-82.

Reviewed By

Review Date: 12/20/2010

C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 6

Joint replacement is preferred when a person suffers from injury and relatable issues and he or she can't move their joints and faces difficulties while doing their daily life activities. In such cases, doctors suggest the patients go for Joint replacement surgery.

A shoulder replacement surgery is not much preferred, but it is adopted as and when required during cases of injury in the shoulder and any other deterioration.

Shoulder replacement involves either replacing just the head of the ball (humerus bone) or both the ball and socket. A patient needs to be physically and mentally prepared for shoulder replacement surgery. The doctors will give you the entire information relating to the preparations and procedures.

It usually takes few months to recover from the injury, thus it is important to plan things and make the necessary actions.

Ranka Hospital, Pune provides the best facilities and treatment for shoulder replacement surgery.