Search results for: Shoulder arthroplasty
Shoulder Arthroplasty: Main Stages, Shoulder Replacement Operation Technique
2017-12-23 01: 36801 Play Stop Download
Joint endoprosthetics. The service life of endoprosthetic joints. CELT.
2017-02-11 05: 03100,762 Play Stop Download
Endoprosthetics of the shoulder joint with comminuted fractures of the proximal shoulder.
2018-05-11 15: 21130 Play Stop Download
Feedback on the operation of shoulder joint endoprosthetics
2017-04-25 03: 19834 Play Stop Download
2011-06-07 01: 37622 Play Stop Download
Prosthetic shoulder joint video. Video about shoulder joint prosthetics. 12+
2018-05-16 03: 001,245 Play Stop Download
shoulder joint endoprosthetics endoprosthesis
2017-03-12 00: 15117 Play Stop Download
bilateral total shoulder arthroplasty
2017-03-12 00: 2081 Play Stop Download
NEW Rehabilitation Protocol for Shoulder Arthroplasty
2018-06-18 09: 4183 Play Stop Download
Rehabilitation after Bankart operation
2011-12-26 04: 5927,334 Play Stop Download
Replacement of the shoulder joint in Israel (review)
2014-03-18 02: 11188 Play Stop Download
Prevention and rehabilitation of the shoulder joint
2017-05-04 02: 56429 Play Stop Download
Joint endoprosthetics. Joint endoprosthesis replacement surgery. CELT.
2017-02-16 07: 174,296 Play Stop Download
Joint endoprosthetics. Piece approach to arthroplasty. CELT.
2017-02-12 02: 231,514 Play Stop Download
Emergency room. Endoprosthetics – a new chance for the shoulder joint
2017-09-08 43: 56170 Play Stop Download
Hip arthroplasty. The operation of hip arthroplasty.
2016-10-28 02: 3913,676 Play Stop Download
2014-10-23 02: 192,432 Play Stop Download
Rehabilitation after shoulder surgery
2018-01-30 02: 36761 Play Stop Download
Endoprosthetics of the elbow joint (Vyatka GTRK)
2013-12-24 02: 371,630 Play Stop Download
Total shoulder joint replacement: the facts
- Length of stay at the clinic: 5 days
- Duration of rehabilitation: 28 days inpatient (Gilchrist bandage 24/7)
- Outpatient rehabilitation: 14 days (Gilchrist bandage at night)
- The earliest flight home: 10 days after surgery
- Recommended flight home: 14 days after surgery
- Duration of inoperability: 6 weeks
- Recommended duration of disability: 6 weeks
- The average cost of replacement / endoprosthetics of the shoulder joint: 17,000 euros
Prosthetic joints can be partial or complete. Partial prosthetics involves replacing the head with a prosthesis, while the articular cavity does not undergo changes.
A complete or total arthroplasty, is a procedure in which an artificial joint is implanted as a whole, after which rehabilitation is required. Often, arthroplasty is the only way to restore the lost functioning of the upper limb to a person.
If the operation and rehabilitation were successful, more than 90% of patients, according to statistics, do not feel the presence of a foreign body in the future and feel well.
Such positive results were made possible through the use of innovative materials that have similarities with the tissues of the human body.
Excellent wear resistance of materials makes them able to fully replace the shoulder joint, providing a person with comfort when worn for a long time.
Indications for endoprosthetics
Endoprosthetics is prescribed if there is a chronic disease of the bone tissue and joint; with congenital malformations and injuries. Implantation is necessary for the following pathologies:
- Osteonecrosis of the head in the joint. The pathological process affects the head of the humerus, on which the resorption or dying of cells begins,
- Fracture in the proximal part of the shoulder. For example, dislocation of the posterior and anterior humerus. In addition, shoulder joint arthroplasty is performed when the head is split, as well as multi-fragment or impression fractures,
- Posttraumatic arthrosis. In this case, it becomes necessary to replace the joint, if after a fracture the bones have grown together incorrectly, and it is impossible to remedy the situation by other methods.
- A fragmentary fracture that occurred in the articular cavity of the scapula, can provoke a dislocation of the head, which will make the shoulder joint unstable,
- Congenital dysplasia
- Arthropathy rupture on the rotational cuff. Such degenerative-dystrophic processes appear after severe damage to the rotator cuff,
- Progressive rheumatoid arthritis.
All the above pathologies are united by one characteristic: irreversible consequences are observed in the shoulder joint. Thus, endoprosthetics is an operation that is the only possible solution to this situation.
It should be understood that the effectiveness of the intervention depends on the degree of destruction of the joint. If there is insufficient function of the arm, then it is not recommended to delay the replacement of the shoulder joint.
The operation is performed in case of severe pathological changes, which are accompanied by a pronounced dysfunction of the joint, an intense pain syndrome, a decrease or a disability. Intervention can be indicated in the following diseases and conditions:
- Deforming arthrosis.
- Rheumatoid arthritis.
- Damage to the knee joint due to gout or psoriasis.
- Aseptic necrosis of the condyle of the femur.
- Intra-articular fractures of the tibia.
- Intra-articular fractures of the femur.
- Ankylosing spondylitis (in the presence of osteoarthrosis).
- Neoplasms of the knee joint.
- Condition after intraarticular fractures of the tibia and femur.
Usually, surgery is performed in cases when other methods of treatment are not sufficiently effective, when the disease progresses rapidly or when the articular surfaces are destroyed so that the normal function of the limb cannot be restored by other means. The selection of the endoprosthesis is carried out on the basis of X-ray and CT data.
In traumatology, absolute and relative indications for endoprosthesis replacement are distinguished. For absolute contraindications include:
- Chronic diseases of the pulmonary and cardiovascular systems in the stage of decompensation.
- Foci of purulent infection (pustular skin lesions, tonsillitis, chronic otitis media, chronic sinusitis, carious teeth).
- Mental disorders and disorders of the neuromuscular regulation, in which the risk of complications in the postoperative period increases.
- Acute and chronic infectious lesions of the knee joint.
- Ongoing growth in children and adolescents.
- Acute thrombophlebitis of the lower extremities.
The group of relative contraindications include cancer and severe obesity. As contraindications also consider the patient’s doubts about the need for surgery or his unwillingness to actively participate in rehabilitation activities after surgery.
Surgical intervention is performed under general anesthesia or conduction anesthesia. The articular surfaces are exposed, their upper parts are cut off. Subject to healthy bone tissue and intact ligamentous apparatus retain. Cut articular surfaces are replaced with prostheses that are attached to the bone with the help of special cement or cementless method. To ensure cushioning and to ensure that the new articular surfaces slide easily during movement, a polymer liner is installed between them. Then proceed to the correction of the tension of the ligaments of the knee joint. With degenerative changes in the ligamentous apparatus, additional prosthetics of the ligaments are performed. The wound is sutured, drained, closed with an aseptic bandage.
Features of shoulder arthroplasty
The fact that the shoulder joint is the most mobile joint in the human body determines the high load on it and the susceptibility to injury. Anatomically, the spherical joint consists of two elements – the articular cavity and the humerus, so the type of operation where both parts are replaced with implants is called total arthroplasty.
Along with a complete endoprosthesis, the following operations are performed:
- Hemiarthroplasty or surface cartilage endoprosthesis, the bone itself is not implanted in this case.
- Shoulder Reversing Endoprosthesis Installation – Suitable for cases of severe damage to the rotator cuff as a result of injury or arthritis.
- Unipolar prosthetics is the replacement of one of the components of a joint, either a hollow or a head.
Implants from various materials are used as “substitutes”. So the head is often replaced by a metal implant, and the articular cavity is replaced by an implant of soft plastic, as close as possible to the physical properties of natural cartilage.
What cases require endoprosthetics?
The indications for shoulder arthroplasty are determined by the pathological condition of the joints, the result of which is:
- Difficult multi-fragment fracture of the shoulder.
- Fracture of the articular cavity.
- Incorrect accretion of the head of the shoulder after a complex fracture.
- Congenital pathologies of the shoulder joints (dysplasia).
- Necrotic and infectious lesions of bone tissue.
Among the reasons that lead patients to the decision about the operation, most often we are talking about rheumatoid arthritis. It is this disease, characterized by damage to the connective tissue, destroys the bone tissue of the joint, leads to the pathological proliferation of the synovial membrane, deprives the joint of the ability to function normally.
- Severe osteoporosis
- Bacterial infections
- Neurological paralysis
- Bone Necrosis
- Mental disorders
- Age over 75 years
Problems with the immune response of the body are defined as a contraindication in each case individually.
At the preparatory stage, the patient is examined for infectious foci. The presence of infection in the body, regardless of the location of the location – the kidneys, lungs, gums and
If the patient is constantly taking certain types of medications, the surgeon can adjust the dosage regimen on the eve of the surgery.
Prosthetics of the shoulder joint is carried out in cases where the restoration of its function by other methods is impossible.
These situations include:
- congenital articular dysplasia – a condition that is extremely rare;
- rheumatoid arthritis with complete destruction of the head of the shoulder;
- severe osteoarthritis;
- post-traumatic necrosis of the head of the shoulder;
- fractures with inability to restore articular structures;
- Hass disease, accompanied by gradual necrosis of the head of the shoulder.
Since the operation is quite difficult, the decision to conduct it must take a doctor. Before that, all alternative treatments should be tried. If it is proved that they are ineffective, in this case, prosthetics are prescribed.
Stages of operation
Surgery is carried out after a comprehensive examination of the patient, which includes:
- general blood and urine tests;
- exclusion of HIV, viral hepatitis, syphilis;
In some cases, magnetic resonance or computed tomography is required.
Types of arthroplasty
Endoprostheses may vary in their characteristics. The technique of their installation differs. This is determined individually for each patient.
There are several types of endoprosthesis replacement surgery:
- Superficial. In this case, only the replacement of the humeral head, or rather, the cartilaginous layer, is carried out.
- Single pole. In this type of operation, a complete replacement of the head of the shoulder or the articular cavity of the scapula is made.
- Total A complete replacement of the destroyed joint.
Endoprostheses are made by different companies, both Russian and foreign. Their price varies slightly and mainly depends on the materials used.
For intervention, there is a specific instruction that is practically the same with different types of prosthetics. Initially, a person is injected into anesthesia – most often use endotracheal, less often mask.
A wide incision is made in the shoulder area and removal of the deformed joint. Then the leg of the prosthesis is installed in the canal of the humerus, the scapula is replaced and the elements of the endoprosthesis are aligned.
Then the wound is sutured. The operation lasts about 3 hours. Details of surgery are presented in the video in this article.
Immediately after the operation, the arm is fixed with a special bandage for a period of 24 hours. In order to prevent postoperative infection, antibacterial drugs are prescribed. In the presence of pain, analgesics are indicated.
Rehabilitation after arthroplasty begins on the second day. It consists of several types of procedures.
The operated shoulder is massaged to:
- prevention of stagnation;
- improve microcirculation;
- eliminate muscle spasm;
- relieve pain.
Massage starts from the first day of the postoperative period. First, it is carried out with light stroking movements. As the wound heals, the massage becomes more intense.
After endoprosthetics of the shoulder joint, exercise therapy begins with minimal movements in the operated limb. The movement is performed until the appearance of pain, and then continue “through the pain”, little by little, constantly increasing the amplitude. Below are the main exercises and photos.
Table. Gymnastics after arthroplasty: