Surgery

Total Shoulder Arthroplasty

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Total Shoulder Arthroplasty, Shoulder Replacement Surgery, Shoulder Arthroplasty

  • Definitions
  1. Glenoid and humeral head replacement
  • Indications
  1. Severe Shoulder Osteoarthritis
  2. Shoulder Pain and loss of function refractory to conservative therapy or prior surgery
  3. End-stage rotator cuff Arthropathy
  4. Osteonecrosis
  • Contraindications
  1. Recent infection
  2. Neuropathic joint
  3. Deltoid or rotator cuff complete paralysis
  4. Debilitating comorbid illness
  5. Shoulder Instability that cannot be surgically corrected
  • Efficacy
  1. Most effective and long-lasting procedure for severe Shoulder Arthritis
  • Procedure
  1. Performed under general Anesthesia with supplemental Regional Anesthesia in some cases
  2. Minimal blood loss
  3. Replacement
    1. Glenoid fossa resurfaced with solid polyethylene part
    2. Humeral head and neck replaced with metal prosthesis
  • Protocol
  • Post-operative Management
  1. Sling used for 3-6 weeks after surgery
  2. Post-operative rehabilitation
    1. Day 1
      1. Start active range of motion of elbow, wrist and hand
      2. Start passive range of motion of Shoulder
    2. Day 21
      1. Start pulley Exercises
    3. Day 35
      1. Start Isometric Exercises
  • References
  1. Edwards (2003) J Shoulder Elbow Surg 12(3):207-13 [PubMed]
  2. Gartsman (2000) J Bone Joint Surg Am 82(1):26-34 [PubMed]
  3. Millet (2008) Am Fam Physician 78(5):605-11 [PubMed]