Shoulder Replacement

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What is Shoulder Replacement?
Shoulder replacement is a complex surgical procedure that involves replacing the shoulder joint with prosthetic implant.
GOALS- The goal of shoulder replacement is to remove the patient’s arthritic humeral head, replace it with the metal “ball” component attached to a stem that extends down inside the patient’s upper arm bone. Then a plastic socket is placed over the surface of the patient’s own.

What leads to shoulder replacement?

  • Arthritis
  • Fractured or broken shoulder.
  • Avascular Necrosis


How can it be Diagnosed?

  • X-Rays
  • Ct Scan,
  • Magnetic Resonance Imaging (MRI)
  • EMG Test, Or
  • Nerve Conduction Test


What are the Types of shoulder replacement and resurfacing?

  • Total Shoulder Replacement (TKR)
  • Partial Shoulder Replacement (PKR)



Total shoulder replacement (Traditional Shoulder Arthroplasty): - Sometimes called traditional shoulder replacement or traditional shoulder arthroplasty, this surgery replaces the original ball-and-socket surfaces of the shoulder with similarly shaped prosthetic. It is used for treating shoulder arthritis.
Reverse shoulder replacement (Reverse Total Shoulder Arthroplasty):- The surgeon reverses the position of shoulder joints ball and socket. The positions of the shoulder joint's ball and socket. At the humerus, the ball is replaced while the shoulder's natural socket is fitted with a prosthetic ball. It is used for patients whose damaged rotator cuffs make them ineligible for traditional shoulder replacement.
Partial shoulder replacement (Stemmed Hemiarthroplasty): - In shoulder hemiarthroplasty, the arm's humeral head is removed and replaced with a prosthetic ball, but the natural socket is kept.
Ream and run: - During this version of a partial shoulder replacement surgery, the natural socket is kept; however, the surgeon might use special tools to smooth and reshape this socket to facilitate better shoulder joint movement. This process is called a hemiarthroplasty with non-prosthetic glenoid arthroplasty or, "ream and run."
Shoulder Resurfacing (Resurfacing Hemiarthroplasty): - The damaged humeral head is fitted with a rounded cap to provide a better joint movement. Resurfacing does not require the complete removal of the natural humeral head nor the insertion of a prosthetic humeral stem.

What are the types of implants used?
There are many different types of implants that are used for an anatomic shoulder replacement. They all share the same basic components: a metal ball that rests against a plastic (polyethylene) socket. In a reverse shoulder these components, while still metal and plastic, are “reversed”, the metal ball is attached to the patient socket, and the plastic socket is attached to the upper humerus.
The polyethylene socket is often cemented to the bone surrounding it, so that fixation to the bone is immediate. The prosthetic ball has a stem that is usually placed inside the humerus without the need for cement.
A new implant, The Comprehensive Primary Shoulder System, with a ball made of cobalt chrome and a stem made of titanium metal, featuring modular (separate) components; the ball, stem, and socket all fit together to provide a more customized fit. The ball component features Versadial, which allows for the new humeral head to be “dialled in” to conform to the patient’s exact anatomy, and the stem was designed to be cement less, providing the opportunity for the ingrowth of bone into the prosthesis.
The socket also features a metal peg permitting native bone to grow into the implant.

What are the Recent Advances?
Suture anchors: - Suture anchors have undergone remarkable changes over time, and the newer designs have focused on greater load to failure strength, ease of insertion, and ability to accommodate multiple sutures. The most recent innovations address the issue of potential revision surgery.
Bioabsorbable suture anchors: - Suture anchors basically function to attach soft tissues to bone; they were initially made of metal, but lately have been replaced by bioabsorbable suture anchors. Bioabsorbable fully threaded suture anchors provide higher pull out strength in poor quality bone. The fully threaded design also prevents anchor pull back as seen in countersunk design.
Bioabsorbable materials: - Composed of Poly L-lactic acid (PLLA) and β-tricalcium phosphate (β-TCP) have better osteoconductive and bioresorbable qualities leading to early bone formation. Polyether ether Ketone (PEEK) is another thermoplastic material used in suture anchors with excellent stability and biocompatibility.
Knotless double row repairs: - The use of fully threaded anchors and forming a knotless construct using two anchors medially and two lateral locks can provide a low profile secure fixation with increased tendon to bone contact. Bioabsorbable sutures with titanium tip allows direct push in technique of suture insertion minimizing the need to prepare a bone channel for the lateral row, where soft tissue can sometimes obscure the view.

What is the treatment duration?

  • It takes around three hours for the complete procedure. The hospital stay is estimated to be 2-3 days.


What is the success rate?

  • The success rate for shoulder replacement 80-90%


Orthopedics Hospitals in India

Orthopedics Top 20. Top Ranked Hospitals for Orthopedics in India. Get Opinion and cost estimate from any three Hospitals Times of India National Rank in Orthopedics The Week National Rank in Orthopedics
Medanta Hospital Gurgaon Delhi India
Medanta – The Medicity is one of India's largest multi-super specialty institutes located in Gurgaon, a bustling town in the National Capital Region. Founded by eminent cardiac surgeon, Dr. Naresh Trehan, the institution has been... + Read More
Size of Hospital (Beds) : 1,250
Accredited By :
  • JCI
  • NABH
1 8
Fortis Memorial Research Institute - Gurgaon India
Fortis one of their leading health care centers is located at Guargaon. Fortis hospital Guargaon Set up over 11-acres, with a provision of 1000 beds. The Fortis Memorial Research Institute (FMRI) is a quaternary care and multi-speciality... + Read More
Size of Hospital (Beds) : 1000
Accredited By :
  • JCI
  • NABH
2
BLK Hospital New Delhi India
In 1930 , at Lahore Dr. B.L. Kapur an distinguished Obstertrician and Gynaecologist set up a Charitable Hospital. He moved to post-separation India and set up a Maternity Hospital at Ludhiana in 1947. In 1956 on the request of the Prime... + Read More
Size of Hospital (Beds) : 650
Accredited By :
  • JCI
  • NABH
3
Apollo Hospitals Chennai
In 1983 , the Apollo Group established the flagship hospital named as Apollo Hospital , Chennai. The Hospital has 60 departments organized by Internationally Trained Doctors , having hi-tech facilities of vaious health disorders and... + Read More
Size of Hospital (Beds) : 500
Accredited By :
  • JCI
  • NABH
4 6
Indraprastha Apollo Hospital Delhi India
The India’s First Hospital which is Internationally Accredited by Joint Commission International(JCI) is the Indraprastha Apollo Hospital, New Delhi. It is the best multi-speciality tertiary acute care hospitals with over 700 beds. It... + Read More
Size of Hospital (Beds) : 718
Accredited By :
  • JCI
  • NABH
5 10
Jaslok Hospital Mumbai India
Jaslok Hospital was set up in 1973 with a very simple mission. Our founders, Jasoti and Lokoomal Chanrai, wanted to ensure that we provide the best possible medical care using state-of-the-art technology to every single patient,... + Read More
Size of Hospital (Beds) : 600
Accredited By :
  • JCI
  • NABH
6
Sir Ganga Ram Hospital Delhi India
Sir Ganga Ram Hospital is a 675-Beded multi-speciality state-of-the-art Hospital in India. It provides comprehensive Healthcare India services, and has acquired the status of a premier medical institution. It is the only hospital in the... + Read More
Size of Hospital (Beds) : 675
Accredited By :
  • NABH
7 13
Fortis Hospital Mumbai India
Fortis Hospital, Mulund is a JCI accredited, 300-bed multi-speciality tertiary care hospital providing a range of diagnostic and treatment services. With cutting edge technology, highly skilled and experienced surgeons and paramedical... + Read More
Size of Hospital (Beds) : 300
Accredited By :
  • JCI
  • NABH
8
Dr. L H Hiranandani Hospital Mumbai India
Dr L H Hiranandani was the inspiration behind the edifice. He was born in 1917 in Thatta, Sind (now in Pakistan). The family migrated to Mumbai in 1937. He completed his medical education in 1942. He was keen to further his education and... + Read More
Size of Hospital (Beds) :
Accredited By :
  • JCI
  • NABH
9
Max Super Speciality Hospital - Patparganj New Delhi India
Max Multi Speciality Hospital, Patparganj, subsidiary of Max healthcare that have 11 top hospitals in Delhi- NCR, Punjab and Uttarakhand with over 1900 bedding facilities including 525 ICU bedding, 2100 world class doctors. They follow a... + Read More
Size of Hospital (Beds) : 500
Accredited By :
  • JCI
11
P.D. Hinduja National Hospital Mumbai India
Established in the early 1950's under the leadership of the late Shri P.D. Hinduja, our vision is to deliver quality healthcare. As an ultramodern tertiary care hospital in Mumbai, India we are motivated to lead the pathway to medical... + Read More
Size of Hospital (Beds) : 400
Accredited By :
  • JCI
  • NABH
12 15
MGM Hospital Mumbai India
The Mahatma Gandhi Mission (MGM) New Bombay Hospital Vashi is one of the most advanced multi-specialty tertiary care centres in the heart of Navi Mumbai in India. Since 1993, the hospital has experienced rapid growth to become a key player... + Read More
Size of Hospital (Beds) : 176
Accredited By :
  • JCI
  • NABH
13
Dr. Balabhai Nanavati Hospital Mumbai India
The iconic healthcare institution of Mumbai, Dr. Balabhai Nanavati Hospital, blessed by Mahatma Gandhi and inaugurated in 1950 by India’s first Prime Minister Jawaharlal Nehru, is now reintroduced asNanavati Super Speciality Hospital.... + Read More
Size of Hospital (Beds) : 350
Accredited By :
  • JCI
  • NABH
14
Apollo Hospital Hyderabad India
Apollo hospital , Hyderabad is the best hospital in the world , in terms of technical expertise , deliverables and outcomes. The first health city in Asia and a perfect example of an integrated healthcare system offering solutions across... + Read More
Size of Hospital (Beds) : 350
Accredited By :
  • JCI
  • NABH
18
SIMS Hospital Chennai India
SIMS Hospital – Vadapalani, Chennai renders 360 degree advanced tertiary healthcare services with multi-super speciality and, very soon, a state-of-the-art multi-organ transplant service. With the finest combination of experience,... + Read More
Size of Hospital (Beds) : 350
Accredited By :
  • JCI
  • NABH
19
Continental Hospitals, A Gleneagles Facility Hyderabad India
Continental Hospitals is a part of the Parkway Pantai Ltd. Parkway Pantai is one of the region's largest integrated private healthcare groups with a network of 22 hospitals and more than 4,000 beds throughout Asia, including Singapore,... + Read More
Size of Hospital (Beds) : 750
Accredited By :
  • JCI
  • NABH
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