Arthrosis - Shoulder Joint Replacement - Endoprosthesis - TEP Joint Replacement - Shoulder Surgery
If the shoulder is affected by osteoarthritis and there are constant pains when getting dressed, combing hair, or taking a shower, a serious consideration should be the replacement of the degenerated joint surfaces of the shoulder. Although, today a joint replacement surgery - artificial shoulder joint - is a routine procedure for an orthopedic shoulder specialist, it will significantly improve the life quality of person suffering from this painful condition.
What causes osteoarthritis? Compared to other joint diseases, osteoarthritis of the shoulder joint is rare. The articular cartilage of the shoulder is in fact in comparison to the knee and hip joint used significantly less in daily life. Common cause of arthritis of the shoulder (osteoarthritis) is a preceding accident (broken bone, dislocated shoulder, and severe compression) or a tendency to generalized osteoarthritis, i.e. a certain individual cartilage weakness.
How is osteoarthritis of the shoulder joint diagnosed?
Important clues for the presents of shoulder osteoarthritis is pain occurring during movement of the shoulder, sharp shoulder and upper arm pain, and also nagging pain during rest periods. Often the movement of the shoulder is progressively restricted and the patient notices movement noises. An X-ray will show whether an advanced degenerative joint disease of the shoulder is present. In addition to magnetic resonance imaging (MRI), it is useful to obtain a detailed study of the soft tissues (tendons, bursa, etc.).
What is the optimal treatment of osteoarthritis of the shoulder joint?
The treatment depends firstly on the extent of wear (arthrosis) and the severity of the symptoms reported by the patient:
In the early stages of osteoarthritis, usually conservative treatment with anti-inflammatory drugs (ointments, tablets), ice packs, and physiotherapy is sufficient. These measures help to relieve the pain and to retain mobility. Heat, electrical therapy, and possibly alternative measures such as acupuncture can improve the painful strain of the muscles. In the advanced stages, additional treatment with injections might become necessary. For example, hyaluronic acid to provide lubrication to the affected joint can improve the condition. Arthroscopic surgery is also an option to improve the mechanics of the shoulder joint.
If, however, the pain persists, such as in patients with advanced osteoarthritis, implantation of an artificial shoulder joint should be considered.
If an artificial joint is necessary, which is the best?
Basically, there are no "good" and "bad" endoprosthesis. Today, depending on the individual damage, technically varying types of artificial joints are available to replace the shoulder joint, partially (hemiarthroplasty) or completely (total joint replacement). With the new rotator cuff (sometimes also called rotator cup) prosthesis, it is only the worn humeral head that is virtually crowned. The correct type of prosthesis and the appropriate prosthesis size are selected according to the individual physical conditions. The new joint components (titanium) are usually bonded to a two-component adhesive onto the previously specially prepared bone. With improved materials and enhanced anchorage, the average life of an artificial shoulder joint is about 15 years or more. Due to the improved prosthetic designs, when the prosthesis is worn, surgery to replace the worn prosthesis is possible. Accordingly, even in younger patients joint replacement operations are performed if necessary.
What you should know before joint replacement surgery!
Although, the artificial hip and knee replacement is performed more frequently, currently an estimated 10,000 artificial shoulder joint implantations are performed per year in Germany. Consequently, shoulder replacements have become a routine for orthopedic shoulder specialists. Nevertheless, like with any medical procedure, there are risks that must be discussed prior to surgery. Overall risks are for example complications that can occur in any surgery and that may limit the desired surgical outcome. These include infection, wound healing, or thrombosis. The risks of surgery and what can be done to minimize such risks, should be discussed with the surgeon in detail prior to the surgery. Additional risk factors are diseases the patient might have prior to surgery and/or his or her physical condition. These risks need to be considered and discussed with the anesthetist prior to the surgery. Most joint surgeries are performed with the patient receiving general anesthesia. The surgery itself will last between 1.5 and 2.5 hours. The pain after surgery is usually not very strong due to improved anesthesia methods and appropriate pain medication.
What happens after the joint replacement surgery?
After surgery, the shoulder should be mobilized again as soon as possible. Although, the patient is fitted with a bandage to protect the wound for a about 3 weeks after the surgery, physiotherapy and home exercises started at the first day after surgery, are vital for optimal healing. The hospital stay itself is to be expected to last 3-8 days. Further rehabilitation takes place either during an approximate 3-week stay in an appropriate rehabilitation center, or as an option on an outpatient basis. How long the physiotherapy is to be continued should be decided in the follow-up consultations. With normal everyday stress, the patient generally obtains full mobility again after a few weeks. Whether the patient can participate in sports again after a shoulder joint transplant, must be decided by the treating physician and must be discussed with the patient.
Your specialists for shoulder joint replacement surgeries at the KLINIK am RING in Cologne have extensive experiences with the treatment of arthrosis of the shoulder joint. They offer the full range of effective therapies, including the implantation of artificial shoulder joints. In 2004, they founded the WEST GERMAN KNEE & SHOULDER CENTER. After comprehensive examinations and careful assessment, you will receive your individual, optimal treatment plan for shoulder osteoarthritis.