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15.09.2014

Shoulder replacement surgery, home remedies for stiff neck and shoulder pain - Within Minutes

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Shoulder joint replacement surgery (also called shoulder arthroplasty) can effectively ease pain from shoulder arthritis. The shoulder is made up of three bones: the scapula (shoulder blade), the humerus (upper arm bone), and the clavicle (collarbone). The shoulder needs a functioning rotator cuff to remain stable as well as to create a joint capsule to hold the joint fluid that lubricates the joint. The answer to this dilemma was to rethink the mechanics of the shoulder joint and design an artificial shoulder that worked differently than the real shoulder joint. Other reasons to consider a reverse shoulder replacement include failed rotator cuff surgery leading to a pseudoparalytic shoulder even without arthritis. Older patients with very severe fractures of the head of the humerus appear to do very well with reverse shoulder replacements as opposed to a standard shoulder replacement. Like any arthritic condition, cuff tear arthropathy of the shoulder may respond to anti-inflammatory medications such as aspirin or ibuprofen.
Physical or occupational therapy may be suggested to help you regain as much of the motion and strength in your shoulder as possible before you undergo surgery. When cuff tear arthropathy of the shoulder requires replacement of the painful shoulder with an artificial shoulder joint, a reverse shoulder replacement may be recommended. You may also need to spend time with the physical or occupational therapist who will be managing your rehabilitation after surgery. On the day of your surgery, you will probably be admitted to the hospital early in the morning.
Before we describe the procedure, let's look first at the reverse artificial shoulder itself.
In the normal artificial shoulder prosthesis, the glenoid prosthesis is a shallow socket made of plastic and the humeral component is a metal stem attached to a metal ball that nearly matches the anatomy of the normal shoulder. The reverse shoulder replacement surgery is performed almost identically to the normal shoulder replacement - except different artificial parts are inserted. During the surgery, the humerus is prepared by cutting off the deformed humeral head and reaming the canal to allow for insertion of the humeral stem. A physical or occupational therapist will see you the day after surgery to begin your rehabilitation program. As the rehabilitation program evolves, more challenging exercises are chosen to safely advance the shoulder's strength and function. When your shoulder range of motion and strength have improved enough, you'll be able to gradually get back to normal activities. You may be involved in a progressive rehabilitation program for two to four months after surgery to ensure the best results from your artificial joint. Many patients with a reverse shoulder replacement will be able to lift the arm overhead with little or no pain. Shoulder joint replacement surgery (also called shoulder arthroplasty) is not as common as replacement surgeries for the knee or hip joints.
Like any arthritic condition, osteoarthritis of the shoulder may respond to anti-inflammatory medications such as aspirin or ibuprofen. Some severe degenerative problems of the shoulder may require replacement of the painful shoulder with an artificial shoulder joint. There are two major types of artificial shoulder replacements: a cemented prosthesis and an uncemented prosthesis.


If the glenoid still has some articular cartilage, your surgeon may replace only the humeral head. Your shoulder may be placed in a continuous passive motion (CPM) machine immediately after surgery. Over time, a shoulder without an intact rotator cuff becomes arthritic - the shoulder joint wears out due to the abnormal motion, the instability, and lack of lubrication from the joint fluid. The glenoid component (the socket) was designed to replace our normal shoulder socket with a thin, shallow plastic cup. The solution was to reverse the socket and the ball, placing the ball portion of the shoulder where the socket use to be and the socket where the ball or humeral head use to be. In many cases, however, therapy may not be indicated for severe shoulder arthritis since it may aggravate the pain.
Plain x-rays of the shoulder will allow your surgeon to evaluate the severity of arthritis and the status of the rotator cuff. The chances of developing an infection following artificial joint replacement, however, are low (about one percent). You will have a dressing wrapped over your shoulder that will need to be changed frequently over the next few days.
In the first six weeks after surgery, you should expect to see your therapist two to three times a week. But, certain patients are not candidates for joint replacement of the shoulder because they lack the muscle function necessary to stabilize the joint. This type of wear and tear arthritis in the shoulder is called (rotator) cuff tear arthropathy. This new design led to a much more stable shoulder joint that could function without a rotator cuff. Your doctor will probably want you to try nonsurgical measures to control your pain and improve your shoulder movement, including medications and physical or occupational therapy.
A CT scan is always required before any kind of shoulder replacement to determine the degree of damage to the bones (glenoid and humeral head) for surgical planning. The glenoid component replaces the socket of the shoulder, which is actually part of the scapula. It is difficult to numb only the shoulder and arm in a way that makes such a major surgery possible.
For reverse shoulder replacements, especially for patients with multiple previous surgeries, a superior approach through the deltoid muscle may be used.
There is a greater risk of dislocation right after surgery, before the tissues have healed around the new joint. In the case of artificial knees, you can expect about 12 to 15 years, but artificial shoulder joints tend to loosen sooner.
Your surgeon may have inserted a small drainage tube into the shoulder joint to help keep extra blood and fluid from building up inside the joint. Whatever the type or cause of the arthritis, the shoulder may become painful and difficult to use.
When fractures affect the humeral head, doctors may recommend a shoulder joint replacement. The surgeon determines the type of replacement joint based on your age, your lifestyle, and the surgeon's experience.


The surgeon cuts through the skin and then isolates the nerves and blood vessels and moves them to the side.
A different type of shoulder replacement, called reverse shoulder replacement, may be available for many of these patients and provide pain relief as well as a stable functioning shoulder. Because the shoulder is not a weight-bearing joint, it does not suffer as much wear and tear as other joints. Surgery to repair a rotator cuff tear is fairly common in people who are middle aged and older. There are many people who choose not to have surgery to repair a rotator cuff tear and will simply live with the limitations.
Patients with this type of arthritis would seem to be good candidates for a shoulder replacement, but replacing the shoulder in the typical fashion has not been successful. The artificial joint itself provided more stability by creating a deeper socket that prevented the ball from sliding up and down as the shoulder was raised. A pseudoparalytic shoulder appears paralyzed, but the reason that you cannot raise the shoulder is because the rotator cuff tendons that attach the muscles (that raise the shoulder) to the humerus bone are torn. Your therapist will check your current pain levels, ability to do your activities, and the movement and strength of each shoulder. This lets your surgeon mold the space to anchor the metal stem of the humeral component inside the bone.
The surgeon usually uses the reamer to drill holes into the bone of the scapula and to flatten the deformed glenoid surface so the base plate rests on a smooth, flat surface. The nerves and blood vessels rarely suffer any kind of permanent injury after reverse shoulder replacement surgery, but this type of injury can happen. If you and your doctor can't find ways to control your pain, or if it becomes impossible to use your shoulder for daily tasks, your doctor may recommend shoulder replacement surgery. Research has shown that when the shoulder is being replaced for arthritis, the complete shoulder arthroplasty performs better.
The nerves and blood vessels rarely suffer any kind of permanent injury after shoulder replacement surgery, but this type of injury can happen. The joint capsule has a considerable amount of slack, loose tissue, so that the shoulder is unrestricted as it moves through its large range of motion. The large deltoid muscle that covers the shoulder could be used to more effectively lift the arm, providing better function of the shoulder. Your therapist will teach you how to avoid activities and positions that tend to cause shoulder dislocation. Patients have less pain immediately after surgery and in the long run have a better functioning shoulder with less complications and are less likely to need a second operation. In the shoulder that something is the rotator cuff and the muscles that attach to the tendons. The final result is a shoulder that functions better, is less painful and can last for years without loosening.
A shoulder that dislocates more than once may need another operation to make it more stable.




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