The shoulder is an amazing and uniquely designed joint that allows the arm to rotate and move forward, back, and side-to-side. Depending on a patient’s age and activity level, however, the shoulder’s design can make it prone to pain and a variety of injuries. Rotator-cuff tears, shoulder impingement, as well as osteoarthritis of the shoulder joint can interfere with an individual’s ability to move freely and pain-free, impacting normal function, as well as quality of life. Recent advances in conventional shoulder replacement surgery are being offered by the specialists at Centers for Advanced Orthopaedic Associates of Central Maryland (CAO-OACM) and are benefitting many patients with improved mobility and function with quicker recovery times. Sam Sydney, M.D., orthopaedic surgeon at Orthopaedic Associates of Central Maryland (OACM), explains the options for shoulder replacement surgery and new surgical techniques available to patients.
When is a replacement surgery needed?
Treatment for chronic shoulder pain and arthritis typically starts with first-line therapies such as physical therapy and pain management using medication or injections. In some cases of minor joint injury, minimally invasive arthroscopic techniques may alleviate pain and help with function. However, when these conservative treatments are not successful, it may be time to explore shoulder replacement surgery. Candidates for surgical intervention often present with shoulder conditions such as: A rotator cuff tear, which impacts the muscles that surround the shoulder and control the movement of the shoulder. The risk of rotator-cuff damage increases with age as the muscles and tendons begin to degenerate and weaken. Rotator-cuff tears can occur in younger people following a shoulder injury or from overuse. Osteoarthritis, a degenerative joint disease, is the most common type of arthritis in the shoulder. It typically occurs in adults over the age of 50. Osteoarthritis occurs when the cartilage that lines the joints begins to wear away, causing the bones to rub against each other. Shoulder impingement syndrome is a painful condition that occurs when the tendons in the shoulder are irritated, inflamed, or degenerated from repetitive overhead motions or structural abnormalities. Most patients who opt for surgery have suffered from prolonged pain and/or a major injury to the shoulder. In addition to new surgical innovations, the design of traditional shoulder-replacement implants has greatly improved, providing even better long-term function and pain relief.
Conventional Shoulder Surgery Gets a Modern Update
Over the past several years, conventional shoulder-replacement procedures have benefited from innovations that are improving both recovery time and post-surgery function. The surgeons at OACM offer an exciting new technology called ExacttechGPS®, which uses computer navigation to provide optimal positioning and fixation of the shoulder implant.
How ExacttechGPS Works
ExactechGPS pairs surgeon expertise with an advanced computer system to perform the patient’s shoulder surgery with the goal of improved accuracy and precision. A pre-operative CT scan is first performed to create a virtual image of the patient’s shoulder. The surgeon can then view this virtual image in real-time during the procedure. During the surgery, a tracker is placed on the patient’s shoulder bone that sends data to the surgeon’s computer screen on the patient’s exact anatomical structure and joint movement. This unique technology allows for more consistent and accurate implant placement for optimal postoperative mobility.
Reverse Shoulder Replacement
Another new variation to traditional shoulder replacement surgery is the reverse shoulder replacement procedure. This technique is recommended for people with a completely torn rotator cuff that cannot be repaired, severe arthritis with rotator-cuff damage, or prior failed shoulder surgery. For these patients, traditional total shoulder-replacement surgery would leave individuals with the inability to lift their arms, which is why reverse shoulder replacement is an exciting alternative. In contrast to total shoulder replacement surgery (shoulder arthroplasty), the components of the artificial joint are placed in reversed positions (the position of the ball and socket in the joint are switched) to allow the deltoid muscle at the shoulder to raise the arm. For both the reverse shoulder-replacement and the Exacttech GPS procedure, post-operative physical therapy is recommended to help patients restore range of motion, strength, and joint stability.
What are the Benefits for Patients?
The conventional shoulder replacement has undergone some significant innovations over the years that make recovery easier, provide excellent pain relief, and result in improved post-operative function. I have been practicing orthopaedic surgery for the past 30 years and have seen tremendous progress in the treatment of musculoskeletal problems, including shoulder replacement.
Patients can contact Orthopaedic Associates of Central Maryland at 410-644-1880, 855-463-2663, or visit mdbonedocs.com to schedule an appointment with an orthopedic specialist.