Shoulder Replacement Surgery

Shoulder Replacement Surgery in India

When we talk about the joint that is the most flexible n the body, the shoulder comes to mind. This joint allows you several things like the following:

  1. Rotate your arms to the left
  2. Rotate your arms to the right
  3. Rotate your arms to the front
  4. Rotate your arms to the above

However, this flexibility and to that end, it is susceptible to injuries.

When such injuries happen, here are some non surgical options to look into before you move on to surgical options. That being said, there are times when if you deer the treatment of the shoulder, it can create major problems later. To that end, surgical options should be looked into. Furthermore, if earlier diagnosis is done, it becomes easy for the doctors to be able to ascertain the diagnosis and it can make a major difference in the treatment of the shoulder.

Working of a normal shoulder

  • The shoulder entails a ball and a socket joint. It entails the following three bones:
    • The upper arm bone
    • The shoulder blade and
    •  The collar bone
  • The shoulder joint is formed when the ball at the top end of the arm bone fits with the small socket.
  • Rim surrounds the socket of the Glenoid and is a soft tissue.
  • The smoother and durable surface that is present on the head of the arm bone and the thin inner lining of the joints allows the shoulder joint to move smoothly.
  • The upper part of the shoulder blade is spread over the shoulder joint.
  • At one end the shoulder blade is joined with the collarbone with the acromioclavicular joint. On the other end of the collarbone, it is joined at the breastbone of the body.
  • The joint capsule refers to the thin sheet of fibres that surrounds the shoulder joint. This capsule allows a wide range of motion while providing the much needed stability to the shoulder.
  • The rotator cuff refers to the group of muscles and tendons that attach the upper arm to the shoulder blade. This cuff covers both the shoulder joint and the joint capsule.
  • The reason that you are able to move your arm is because of the muscles that surrounds the rotator cuffs.
  • There is a sac like organ or might as well be a membrane called the bursa. Now, bursa is responsible for providing lubrication between the shoulder blade and the rotator cuffs.

What are the types of shoulder problems?

The shoulder problem entails a plethora of issues like the following:

  1. Tendinitis or the Bursitis:

This type of condition can occur when you are over indulging yourself with repetitive and strenuous activities. These activities entail strenuous physical exercises like the following:

  • Weight lifting
  • Swimming
  •  Painting

Such activities tend to the rub or squeeze the rotator cuff under the acromion or the acromioclavicular joint. Modifying how you do your activities is the initial phase of treatment for this. 

  1. Partial rotator cuff tears:

This form of issue is related to the chronic degeneration that causes inflammation. This in turn tends to develop spurs on the underside of the acromioclavicular joint.

The non surgical treatment of this type of issue is the changes in the activities of the patient. These include light exercise, and occasionally an injection of cortisone. While this form of treatment is successful in the most cases, if they fail, surgery is needed to remove the spurs from the underside of the acromion in order to the repair the rotator cough.

  1. Full rotator cuff tears:

This form of disorder is most often the result of impingement, or partial tearing of the rotator cuffs. This can happen due to the following reasons:

  • Too much weight lifting
  •  Falling
  •  Cuff tears injury while playing.

In most of the cases, the non surgical ways are considered to deal with this issue. However, arthroscopic techniques are sometimes preferred in order to shave of any sort of spurs and to repair the tears. Once the surgery is over with, intense recovery is also required.

  1. Instability

This form of condition occurs when the upper arm is forced out of the of the shoulder socket. This can happen due to a serious sort of injury or if you are overusing he ligaments of the shoulder. There are two types of shoulder instability and they are the following:

  • Sublixation: This is a partial dislocation condition. This happens when the shoulder is partly out of the socket. Even a minor injury at the wrong place can do this.
  • Dislocation: this is a condition where the arm bone slips out of the shoulder socket. It is case with some of the patients where they suffer from a chronic form of instability where they should dislocations tend to repeat often.
  1. Fractured head of the arm bone:

If you fall on an outstretched arm, this is the condition that you will suffer from. It happens mostly in children’s when they fall on the sides with their arms stretched. This can be treated in a non surgical fashion. However, for the more severe conditions it is required that surgery is done in order to mitigate the issue.

  1. Fractures collarbone:

This form of the condition is also common in children where the fall on the side of the shoulder when they are playing. While they can be treated in a non surgical fashion, for a more robust and proper approach and more severe cases, surgical options become a necessity in order to make sure that the shoulder shape is maintained.

  1. Osteothritis or Rheumatoid arthritis:

This is a form of arthritis where the shoulder bone tends to suffer from inflammation due to degeneration of the surrounding tissue. The capsule and the rotator cuffs can be damaged.

  • Osteothritis happens when the articular surface of the joint becomes thin with repeated movement with age.
  • Rheumatoid arthritis happens when there is a sort of chronic inflammation of the shoulder. To be precise of the synovium lining.

What is the procedure of the shoulder replacement surgery?

The reason hat shoulder surgery is done when all the non surgical options have been exhausted and there is still stiffness and pain to deal with in the shoulder area.

The procedure of shoulder replacement surgery involves the following:

  1. Evaluation:
    1. Before the surgical process takes place, the orthopaedic evaluation takes place of the patients. It involves medical history check for that consists of previous surgeries, pain, medications, the duration of the symptoms etc.
    2. There are also physical examinations taken that entail physical assessment of the region that consist of checking for any sort of swelling, deformity or instability.
    3. The imaging tests are done to ascertain if there are any sort of further issues. This is mostly done using the X-rays, MROS or CT scan.

Once all the evaluation process is complete, these are checked by the expert’s to see if there is anything else to consider.

  1.  Preparation of surgery:
    1. You will not be allowed to intake any food or drink after midnight before the surgery
    2. As for the matter of medications, please consult with the orthopaedic before you do so.
    3. Your anaesthologist will consult with you in order to check you have any sort of allergies to certain types of anaesthetic drugs.
    4. Now, once these things are checked and done with, you will be given any of the following form of surgery:
      1. Arthroscopy: in this form of surgery, a tiny incision is made to see inside the joint. This image makes the entire picture of the final diagnosis. Surgical instruments are inserted through these incisions in order to provide surgery.
      2. Open surgery: it is an open form of surgery where you require long term results. Although, even the open surgeries can be done using small incisions as well.

After the surgery comes the rehabilitation process. The process of this rehabilitation is based upon which type of surgery you have opted for.

What comes after the surgery?

After the surgery is over with, several things have to be considered like the following:

  1. Complications: as with any form of surgery, the orthopaedic surgery too involves some form of complications. As low a chance of any of these complications to come up, there is still something to consider to that end. Following matters are taken into a account:
    1. Bleeding
    2. Infection
    3. Blood vessels damage

While the modern surgical techniques  has made it possible there are near no complications of the surgery, it is still necessary for you to consult with the surgeon if you see anything wrong happening. Once the surgery is done, you would feel a bit of stiffness and some tender ness in the region. They are all normal and you should relax. However, if something more severe is happening, you need to get to your doctor as soon as possible.

  1. Once the surgery is complete and a few days have passed, you might feel the following:
    1. You might feel a bit of swelling
    2.  You  might feel a bit of redness and warmth in the region
    3. The bleeding is also possible. However, this form of bleeding is natural and even desirable
    4. You might feel a bit tingling in your arm as well.

Take precaution after the surgery

The shoulder is an extremely complex organ and to that end, you need to make sure that once the surgery is over, you are not over extending yourself. By over extending we mean that over indulging yourself with physical activities. You need to take care of the following after the surgery is over with:

  1. Exercise daily. However, make sure that the exercise that you are doing is a light one.
  2. Furthermore, it is necessary for you to make sure that you do not lift heavy weight.
  3. Take care while you are walking
  4. Make sure that you do not fall
  5. Your diet should entail a high amount of protein coupled with vitamin D and calcium to maintain the bones and the muscles around it.
  6. Always make sure that you take your therapies seriously. Failure to do so might affect you n the long run.  

 

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MEET OUR EXPERIENCED DOCTOR

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Dr. Ramneek Mahajan

Director (Orthopaedics & Joint Replacement) & Head of Unit-1

Dr. Ramneek Mahajan has over 15 years experience handling Orthopedics & Joint Replacement cases. Dr. Mahajan has to his credit approximately 2500 Joint Replacements and more than 10000 other Orthopedic & Spine surgeries. His interest lie in Primary, Revision Joint Replacement & Arthroscopy.