Total Shoulder Replacement
The fact that the shoulder joint is the most mobile joint in the human body determines the high stress on it and the susceptibility to injury. Anatomically, two elements are part of the spherical joint – the glenoid cavity and the humerus, therefore the type of operation when both parts are replaced with implants is called total shoulder replacement.
It is an operation that allows surgically restoring the destroyed parts of the surface of the humerus or scapula. Such a surgery is in demand among patients of different ages – the younger contingent more often needs to install an implant due to trauma, the elderly – due to pathological deterioration of the joints.
Indications for total shoulder replacement are determined by the pathological condition of the joints, the result of which is:
- Complicated multi fragment fracture of the shoulder.
- Fracture of the glenoid cavity.
- Incorrect fusion of the shoulder head after a complex fracture.
- Congenital abnormalities of the shoulder joints (dysplasia).
- Necrotic and infectious bone lesions.
Many of these pathologies trigger the so-called vicious circle: tissue destruction leads to a deterioration in the microcirculation of the joint, and a deficiency of nutrients and oxygen, which is associated with insufficient blood supply, worsens the condition of the articular structures.
At the preparatory stage, the patient is examined to identify infectious foci. The presence of an infection in the body, regardless of the location – kidneys, lungs, gums, etc. – can provoke complications after surgery and implant rejection.
If the patient is constantly taking certain types of medications, the surgeon may adjust the regimen before the surgery.
Outpatient Total Shoulder Replacement
Along with endoprosthetics, such types of operations are performed as:
- Hemiarthroplasty or superficial endoprosthetics of the cartilaginous surface, the bone itself in this case is not implanted.
- Reversible Shoulder Endoprosthesis – Suitable for severe rotator cuff injuries due to trauma or arthritis.
- Unipolar prosthetics is the replacement of one of the constituent elements of the joint, either the cavity or the head.
Implants made of various materials are used as “substitutes”. So the head of the bone is often replaced with a metal implant, and the glenoid cavity is replaced with an implant made of soft plastic, which is as close as possible in physical properties to natural cartilage.
Recovery for Outpatient Total Shoulder Replacement Surgery
In order for rehabilitation after the installation of artificial joints to be as successful as possible, the patient must begin to perform the first static exercises as early as 1-2 days after the operation. Rehabilitation exercise therapy begins after the operation by performing simple exercises with a healthy hand, gradually the exercises become more complicated, and after 20 days the patient will be able to perform active exercises with a load of the operated hand.
In addition to restorative procedures, a set of preventive measures is performed that minimize the risk of complications. The preventive program includes:
- rational antibiotic therapy;
- wound treatment;
- prevention of thrombus formation;
- immobilization of the limb, the use of a bandage or bandage;
- breathing exercises.
In the early period of rehabilitation, the procedures are gentle, but the further condition of the muscles, ligaments and the entire joint apparatus depends on them. The first workouts, despite the low level of load, allow you to gradually move on to serious exercises. High-quality implementation of the recommendations of the attending physician and regular implementation of rehabilitation actions will allow the hand to return to its usual motor activity.
Risks and Complications of Total Shoulder Replacement
With any operational treatment, there is a risk of complications. In the case of the above-mentioned surgery, we are talking about the following negative consequences:
- Infectious processes;
- Dislocation of the joint;
- Looseness of the implant components;
- Periprosthetic fracture.
In any of these cases, the problem can be eliminated, but the rehabilitation period increases.