The shoulder joint is considered the most mobile in an individual. Shoulder arthroplasty is an operation during which a completely inoperative part of it is replaced with an artificial element - an endoprosthesis. In some cases, this is the only way to restore lost motor functions of the upper limb.
Brief anatomy of the shoulder joint
The human joint, which performs the most different movements, has a very complex structure. It consists of the head of the humerus, resembling the shape of a ball, and the glenoid cavity of the scapula, which is a flattened saucer. Moreover, the surface area of the humerus significantly exceeds the surface of the articular cavity. This structure explains the frequent dislocations and subluxations in the shoulder joint. To ensure stability, there are:
- Articular lips located along the edges of the glenoid cavity.
- Deep muscles inshoulder joint area. They stabilize and prevent the head of the humerus from moving.
Bone surfaces are covered with articular cartilage, which serves to protect bone tissue and promote better mobility. The synovial membrane around the joint produces synovial fluid, which lubricates the cartilage, eliminating friction. The complex anatomy contributes to the implementation of a large range of movements in the shoulder joint. Shoulder arthroplasty is an operation that requires careful planning and careful management of the muscles in the reconstruction of the joint.
Arthroplasty surgery
Sometimes, under the influence of certain factors, the working surfaces of the shoulder joints wear out and deform. The individual suffers from pain and loses function of mobility in the shoulder. Installation of the endoprosthesis relieves him of discomfort and returns him the motor function of the upper limb. The first prosthesis in the shoulder was installed in 1960. In modern conditions, the operation is not uncommon. It is carried out by a trained team of trauma surgeons, having the necessary equipment and tools. Manipulation is done under general anesthesia, which lasts from an hour to two. Depending on the part of the shoulder joint to be replaced, shoulder arthroplasty is done with the following endoprostheses:
- Total - the entire joint is replaced, i.e. the head and cavity.
- Unipolar - implants designed to replace one element of the joint, most oftenheads.
An artificial implant, with proper rehabilitation, performs all its characteristic functions: the ability to hold a spoon, fasten buttons, write, drive a car. Only an orthopedist can choose the right prosthesis, taking into account all the individual characteristics of the patient.
Indications for surgery
The main indication for shoulder arthroplasty is a significant destruction of the joint resulting from disease or injury. These include:
- Congenital malformations of the joint.
- Advanced stage of rheumatoid arthritis.
- Post-traumatic arthrosis.
- Fracture of the glenoid cavity with comminuted appearance.
- Hass disease, when the cancellous bone that makes up the head of the bone gradually dies.
- Defects in healing of fractures.
All these conditions indicate the irreversibility of the processes that have occurred in the shoulder joint and the impossibility of solving the problem in any other way than arthroplasty. There is no need to delay the operation and hope for a miracle that will not happen.
Preparation for shoulder replacement surgery
In preparation for shoulder replacement surgery, the following examinations should be performed:
- Common blood and urine tests.
- ECG to exclude pathologies of the heart muscle.
- Testing for HIV, syphilis and hepatitis.
- X-ray of the shoulder joint.
- CTand MRI - carried out in extreme cases for special indications.
It is recommended that you report any he alth problems to your doctor. They must be resolved in the period between the dates of the appointment of the operation and its implementation. And also the physician must be informed about the constant use of medications. The selection of the implant is carried out for each patient individually, taking into account the age of the patient, the characteristics of the pathology, chronic diseases, and the expected activity after the operation.
Types of shoulder prosthetics
The following types of surgery are used in orthopedics:
- Total shoulder arthroplasty – a shoulder prosthesis completely replaces the head and glenoid cavity. There are two options: only articular surfaces or use prostheses with legs.
- Superficial - leave the head of the joint, and the worn cartilage cover is replaced with an artificial one.
- Partial - either the head or socket is being replaced.
- Revision or replacement - a worn or loose prosthesis is replaced with a new one.
Rehab
In the postoperative period, the motor functions of the shoulder are restored according to the following method:
- The shoulder joint is fixed using a scarf or sling bandage.
- Therapy of postoperative pain syndrome.
- Antibacterial agents are prescribed to prevent infection.
- Light statistical exercises are allowed on the second day after surgerymanipulation.
For a complete recovery, the patient undergoes a special course of exercise therapy. Rehabilitation after shoulder arthroplasty is divided into two periods:
- Early - the patient performs exercises that help him restore range of motion: abduction of the upper limbs to the sides and forward, flexion and extension at the elbow and wrist, pendulum movements.
- Late - occurs one and a half months after the operation. Gymnastic exercises are aimed at gaining strength: push-ups from the wall and floor, stretching the tourniquet.
The functions of each person are restored individually. Some return to normal life completely, while others perform only the simplest movements necessary for self-care.
Possible complications of shoulder arthroplasty
Rehabilitation in the postoperative period is sometimes complicated by the deterioration of the patient's condition. The joint prosthesis is a foreign body for the body, so there is a possibility of an inflammatory process. Complications are possible after any surgical manipulation. These include: allergy to anesthesia, malfunction of the cardiovascular system.
Although the occurrence of a bacterial infection is observed infrequently, but the onset of inflammation of the tissues around the joint and the spread of infection can lead to additional surgical intervention. The focus of infection can be dental caries, organs of the genitourinary system, trauma to theskin. In addition, dislocation of the prosthesis is possible in the early recovery period. A set of exercises that help strengthen muscles helps prevent this complication.
Get a quote for shoulder replacement surgery
In order to receive assistance for shoulder arthroplasty according to the quota, you must:
- Visit your local doctor.
- Pass a full examination and receive a document confirming the presence of a pathology of the shoulder joint, which allows you to get a quota for free treatment.
- Make photocopies of the following documents: identity documents (passport); SNILS; compulsory medical insurance policy; certificate confirming disability (if any).
- The collected package of documents together with the patient's consent to the processing of individual data, the medical institution is sent to the federal clinic.
- The patient is waiting for a certain time for a call about the date of hospitalization.
- After receiving it, he goes to the clinic to the attending physician, where he receives a referral for treatment.
- The patient arrives at the clinic by the appointed time, having a passport, a referral from the attending doctor.
Manipulation to replace the shoulder joint and the implant itself according to the quota in the federal clinic is a free procedure.
Conclusion
Shoulder joint replacement - shoulder joint replacement is the most effective method that will restore the motor functions of the upper limb. The developed technique enables the individual to live fullyand keep working for years to come.
