Shoulder Arthroplasty: Another Prosthesis
Shoulder arthroplasty
In shoulder arthroplasty, surgeons replace the ends of the damaged upper arm bone (humerus) and usually the shoulder bone (shoulder blade) or cover them with artificial surfaces lined with plastic or metal and plastic. The components of the shoulder joint can be held in place with cement . Or they may be made with materials that allow new bone to grow in the joint component over time to hold it in place without cement.
The upper end of the humerus is shaped like a ball. The muscles and ligaments hold this ball against a cup-shaped part of the shoulder bone. Surgeons often replace the top of the humerus with a long piece of metal that is inserted into the humerus and has a rounded head. If the surface of the cup-shaped shoulder bone that holds the humerus is also damaged, doctors smooth it out and then coat it with a piece of plastic or metal and plastic.
Innovations
Surgeons are now testing a newer procedure called reverse total shoulder replacement for people who have painful arthritis in the shoulder and also have impaired muscles around the shoulder. In this procedure, after the surgeon removes the damaged bone and smoothes the ends, he attaches the rounded joint piece to the shoulder bone and uses the cup-shaped piece to replace the top of the humerus. Initial results are encouraging. This surgery is not suitable for everyone. And not all surgeons have done it. Success depends not only on a careful evaluation to make sure it's the right surgery for you, but also on having a surgeon experienced in doing a total reverse shoulder replacement.
Doctors usually use general anesthesia for arthroplasty. This means you will be unconscious during the operation. But sometimes they use regional anesthesia, which means you can't feel the area of surgery and you're drowsy, but you're awake. The choice of anesthesia depends on your doctor, your general health and, to some extent, what you prefer.
Your surgeon may recommend that you take antibiotics before and after the operation to reduce the risk of infection. If you need to have a major dental work done, your doctor may recommend that you have it done before the operation. Infections can spread from other parts of the body, such as the mouth, to the artificial joint and cause a serious problem.
After Surgery
After surgery, you are probably still taking some medicines. You will gradually take fewer painkillers (pain medicines). You may continue to take medicine to prevent blood clots for several weeks after surgery.
A physical therapist will move your arm to keep your shoulder loose as it heals. The therapist will also teach you how to use a pulley device so you can move your arm when you go home from the hospital. In addition, your therapist may start doing some simple exercises to keep your other arm and leg muscles strong.
Rehabilitation after shoulder replacement begins right away. It's not too demanding at first, but it's very important that you do it. Most doctors will not allow you to use your shoulder muscles for several weeks after surgery. The main goal of rehabilitation is to allow you to move your shoulder as much as possible, so that it will be easier for you to do your daily activities, such as dressing, cooking, and driving. Most people regain about two-thirds of their shoulder movement after surgery. However, other things that affect the amount of movement you regain after surgery are the degree of movement you had before the surgery and whether the soft tissues around the shoulder were also damaged. To get the most benefit from surgery, it is very important that you take part in physical therapy both during your hospital stay and after you are discharged from the hospital.
Most people go home 1 to 3 days after surgery. Some people who need more intensive rehabilitation or those who have no one to help them at home go to a specialized rehabilitation center for more treatment.
If you need recommendations or help in orthopedic surgery and traumatology do not hesitate to contact me.
Dr. Leopoldo Maizo - Orthopedic Surgeon
Firma diseñada por @themonkeyzuelans, contáctalos vía Discord "themonkeyzuelans#9087"
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