Shoulder prosthesis is a medical support that optimizes the person’s living conditions due to the problem that occurs in the structure of the cartilage or flexibility metabolism that provides the formation of the shoulder joint.
The shoulder is one of the most flexible and most mobile joints in the human body. A healthy shoulder joint also helps strengthen the person’s bone structure. Due to the constant movement of the shoulder bone and its components, people may face different health problems over time. This situation becomes more evident especially when the shoulder is actively used.
Other factors that endanger shoulder health include a chronic disorder in the shoulder, shoulder dislocation, or fracture or fall during sports. Thanks to the shoulder prosthesis system developed as a solution to the problem of a broken or damaged shoulder, the damaged shoulder becomes stronger and gains flexibility of movement.
Shoulder prosthesis surgeries both relieve pain and strengthen the shoulder and allow it to move easily. During the surgery, all or part of the problematic shoulder is removed and an artificial joint called a prosthesis is created in its place. A smooth metal or plastic piece is attached instead of the hard and worn joint surface of the shoulder.
Shoulder replacement surgery is a surgical procedure performed when other treatment methods do not provide benefit to patients who have lost their functions and have shoulder pain. Usually, before shoulder replacement surgery, the patient is treated with medication, intra-articular needle therapy and physical therapy methods.
The main conditions that require shoulder replacement surgery can be listed as follows:
The patient has shoulder pain that prevents basic daily life activities and wakes them up from sleep
Limited movement in the shoulder joint
Presence of calcification in the shoulder joint
Development of calcification, pain and dysfunction as a result of serious tearing in the shoulder fibers
Presence of bone decay and tumors defined as avascular necrosis of the bones in the shoulder joint
Comminuted shoulder fractures in elderly patients where fracture treatment and recovery are not possible
Presence of joint calcifications caused by rheumatic joint diseases
X-rays are usually sufficient to diagnose calcification in the shoulder joint. In some cases, computerized tomography may be required to evaluate the patient’s bone integrity. The condition of the muscles and fibers in the shoulder joint can be viewed with MRI, or magnetic resonance. In cases where nerve damage is suspected, EMG tests or nerve conduction studies may be requested to evaluate the nerves.
What is Shoulder Prosthesis?
The process of removing all or part of the bone composition that is damaged, broken, torn or melted due to any reason and creating a prosthetic joint that functions as an artificially created bone is called shoulder prosthesis.
The main point in the shoulder prosthesis procedure is the degree of damage to the patient’s shoulder. If the damage is not too great, the patient will not be directly fitted with a prosthesis. Instead, it may be preferred to apply ancillary treatment methods. These ancillary treatments include physical therapy, medical drug therapy and joint injections. If these treatments do not provide benefit, prosthesis treatment may be on the agenda.
What are the Types of Shoulder Prosthesis?
There are many different types of shoulder prosthesis treatment. This variety may vary depending on the patient’s current damage and recovery process. Prosthesis is frequently used especially in bone lesions that are broken as a result of a shoulder tumor.
The decision of which shoulder prosthesis type to use is made as a result of examinations performed by experts. The shoulder prostheses that are used as a result of the examination can be listed as follows:
In total shoulder prosthesis surgery, a new prosthesis is made in the small area formed in the content of the patient’s shoulder structure. The prosthesis made gains functionality by creating the new content. The process is activated by replacing the circular upper layer of the shoulder head with a new prosthesis along with the changed content.
In reverse shoulder prosthesis surgery, the structure of the person’s shoulder is changed to a circular structure in the prosthesis. The part at the very beginning of the shoulder is turned into the content of the prosthesis, providing a comfortable and flexible movement experience.
In the partial shoulder prosthesis surgery process, there is absolutely no operation on the part inside the shoulder. The part that is processed is the shoulder head, and the shoulder head is changed with the prosthesis made. Thus, the shoulder head can return to the untreated inner socket and gain movement function.
How is Shoulder Prosthesis Surgery Performed?
How shoulder prosthesis surgery is performed may vary depending on the scope of the prosthesis to be applied. Partial change can be made by changing only the round head of the bone, or it is possible to change the bone bed together within the scope of total change. An average 15 cm long incision is made from the collarbone to the arm.
If the head of the arm bone or soft tissue is damaged but the glenoid is intact, in some cases it may be sufficient to replace only the bone head. In this case, the head of the humerus and the head of the arm bone are removed and the arm bone is prepared to hold the stem to be attached. It is possible to attach the stem to the bone with cement. Then, a metal head is placed on the new stem. If the shoulder is broken, the tuberculum is attached to the new stem and the surrounding bone.
In cases where both the head of the arm bone and the socket are worn, a decision may be made to replace the bone head ball and the bed. In this case, first the worn arm bone head is removed and the arm bone is prepared to hold the stem to be attached firmly.
Then, the socket is prepared and usually the plastic cup is fixed in place with cement. Finally, the stem is inserted into the arm bone and the metal round is firmly attached to the new stem. In some cases, and usually when there are irreparable tears in the muscles around the shoulder of patients in the older age group, reverse shoulder prostheses can be applied.
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