The shoulder is a ball-and-socket joint with three main bones: the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle).
In a normal shoulder, the joint is supported by the muscles that surround the shoulder. Shoulder movement is created and controlled by delicate interactions of 30+ muscles, tendons and ligaments.
The rotator cuff is a group of muscles and tendons that enable the arm to be lifted, reach overhead and do activities such as throwing and swimming.
Severe Arthritis of the Shoulder Joint
Arthritis is a condition that affects the cartilage of the joints. As the cartilage lining wears away, the protective lining between the bones is lost. When this happens, painful bone-on-bone arthritis develops. Severe shoulder arthritis is quite painful, and can cause restriction of motion. While this may be tolerated with some medications and lifestyle adjustments, there may come a time when surgical treatment is necessary.
Severe Rotator Cuff Damage
In patients with severe rotator cuff damage, the joint can become unstable, severely restricting the patient's range of motion. Over time, the out-of-balance joint can wear down the lubricating cartilage between bones. Bone starts to rub against bone, causing the pain we know as osteoarthritis.
Indications for Surgery
Shoulder replacement can be extremely helpful to individuals suffering with severe arthritis of the shoulder joint, rotator cuff damage, or a combination of both. Arthritis and rotator cuff damage of the shoulder can be evaluated by X-ray, CT scan or MRI to reveal loss of joint space, soft tissue (rotator cuff) damage and bony changes.
In addition, patients with complex shoulder or upper arm fractures resulting from trauma or osteonecrosis (a condition in which the bone can crumble due to lack of blood supply) may also require a shoulder replacement.
Total Shoulder Replacement
Total shoulder replacement, which involves replacing both sides of the joint - the ball and the socket, is recommended for patients who have severe arthritis that is causing pain, stiffness, and limited motion.
Partial Shoulder Replacement or Hemiarthroplasty
This less invasive procedure involves replacement of the ball or head only with a metal ball and stem prosthesis. The socket portion is left intact. The procedure is for patients who do not have severe degeneration of the socket (glenoid).
Reverse Shoulder Replacement
Reverse shoulder replacement is reserved for patients who have arthritis and a chronic rotator cuff tear or in some instances a failed prosthesis and have no other treatment alternatives. In this procedure, the location of the prosthetic ball and socket components are switched to make use of healthy deltoid muscle rather than the damaged rotator cuff muscles to lift the arm.
How do I know if I am ready for shoulder replacement surgery?
Generally, a patient who has tried the usual treatments for shoulder arthritis, but has not been able to find adequate relief, may be a candidate for shoulder replacement surgery.
Patients who have severe arthritis, irreparable rotator cuff damage, or both that cause unrelenting pain and stiffness in the shoulder, and who are unable to lift their arm for basic activities such as washing, dressing, or eating, may be a candidate for shoulder replacement.
Always consult with your surgeon on whether you are a candidate or ready for shoulder replacement surgery.
What are my expectations after the surgery and are there any risks?
Patients considering the procedure should understand the potential risks of surgery, and understand that the goal of joint replacement is to alleviate pain.
Patients generally find improved motion after surgery, but these improvements are not as consistent as the pain relief following shoulder replacement surgery. Risks of surgery include risks of general anesthesia which tend to be dependent on other medical issues you may have. Consult your surgeon on the specific risks of shoulder replacement surgery that may include: infection, dislocation/instability, loosening of the implant, or damage to the nerve or blood vessels.
What is involved in the surgical procedure?
The surgical procedure is conducted under general or local anesthesia; and generally takes about a few hours to complete.
What is involved in the recovery process?
Patients will work with a physical therapist to resume daily activities and strengthen shoulder muscles.
How much pain will I have?
Shoulder replacement is manageable and well tolerated for the majority of patients. Consult your surgeon about the specifics to post surgery pain management.
How long before the patient can resume activities?
Most patients are able to return to activities within a few months.
Will the alarms go off at the airport?
Your shoulder replacement may activate metal detectors required for security in airports and some buildings. Inform the security agent about your shoulder replacement if the alarm is activated.
DJO Surgical offers Patient ID cards to help inform security, medical, and other related agency or personnel about your shoulder replacement.
Turon Modular Total Shoulder
The Turon Modular Total Shoulder replaces the severely arthritic joint. It involves replacing the head of the upper arm bone (humerus) with a metal ball and stem prosthesis and the socket (glenoid) with a plastic prosthesis. The implant is designed to help reduce the painful symptoms of arthritis.
The Turon Modular Total Shoulder is designed for patients with severe shoulder arthritis. It provides the option and the ability to help adjust to and restore individual patient anatomy compared to conventional shoulder implants.
Reverse® Shoulder Prosthesis
The Reverse Shoulder Prosthesis replaces the severely arthritic joint with irreparable rotator cuff damage. The metal and polyethylene implant mimics the anatomy of the natural shoulder, but reverses it and provides a deeper socket to stabilize the joint. The implant is designed to compensate for the damaged rotator cuff and help reduce the painful symptoms of arthritis.
The RSP® Monoblock is also designed for patients with severe shoulder arthritis and irreparable rotator cuff damage. It can also address complex shoulder or upper arm fractures resulting from trauma.
The DJO Match Point System provides surgeons the ability to customize the placement of the shoulder prosthesis specifically for each individual patient. Starting with a computed tomography (CT) scan, surgeons get a virtual model of the patient's shoulder joint. Your surgeon will use this model to plan the placement of the prosthesis prior to surgery. Once planned, a guide is manufactured and delivered to surgery to match the surgeon's plan to the anatomy during surgery.
DJO Surgical is the first company to offer blended vitamin e polyethylene in both the anatomic and reverse shoulder implant systems. Vitamin e is a naturally occurring anti-oxidant that has been shown to reduce the oxidative properties of the plastic component used in surgery. Along with reducing oxidation, the DJO Surgical e-plus has been tested to reduce long term wear by up to 92%.
What makes the Turon Modular Total Shoulder unique?
The Turon Modular Total Shoulder provides options to help adjust to and restore individual patient anatomy compared to conventional shoulder implants. The Turon addresses both severe shoulder arthritis and complex upper arm fractures resulting from trauma.
Why is the RSP® Monoblock product important news?
Like the Reverse Shoulder Prosthesis, the RSP® Monoblock addresses severe shoulder arthritis and irreparable rotator cuff damage. However, the RSP® Monoblock also addresses complex upper arm fractures resulting from trauma.
What makes the RSP unique?
The RSP Shoulder is an exclusive design that reverses the shoulder anatomy in order to effectively resist the pull of the shoulder deltoid muscle. For patients, this could mean greater range of motion and relief from pain.
Visit http://www.djoglobal.com/djosurgical for more information.