The structure of the shoulder joint is a sphere-slot joint like the hip joint. It is a joint formed between the head at the upper end of the humerus (upper arm bone) and the nest part of the scapula (scapula) called glenoid. It has a wider range of motion than other joints in our body. The muscle surrounding the shoulder joint, ligament tendons supports the joint and moves the joint.
Shoulder prosthesis is a type of prosthesis made to reduce or eliminate pain, restore joint range of motion and improve quality of life in patients with high levels of pain and movement restriction due to arthrosis (cartilage erosion, calcification) in the shoulder joint. The shoulder joint is one of the most frequently moving joints in the human body. The aim of shoulder surgery is to get rid of the patient's pain and to return to daily life activities without any problems.
The first treatment methods usually applied in shoulder problems are drug therapy, intra-articular needle treatments and physical therapy. Surgical treatment is a treatment technique that comes into play when the pain of patients who have to live with this disease increases greatly.
Patients who need treatment should not respond to all other treatments. While pain usually occurs with movement first, it may also occur at rest in the later period and may even be seen as pains that wake up from sleep.
As the damage to the shoulder progresses, swelling and loss of function occur in the joint. In advanced cases, the movement ability of the shoulder joint may be completely lost.In this case, the type of prosthesis that the doctor deems appropriate should be determined and the surgery should be performed.
What Are the Types of Shoulder Prosthesis?
Full Shoulder Prosthesis
In this shoulder prosthesis, a plastic polyethylene socket (slot) is attached to the joint socket with a special adhesive (cement) used in prosthetic surgeries. On the lower side, the metal head is placed on the handle part placed inside the humeral (upper arm) bone canal. In order for this prosthesis to be made, the fibers surrounding the patient's shoulder joint (rotator cuff) must be intact and functioning.
Reverse Shoulder Prosthesis
In this type of prosthesis, the prosthetic parts are metal and plastic, but they are reversed. The metal head is attached to the joint slot. A plastic polyethylene slot is attached to the upper end of the humerus bone on the metal handle. In advanced age patients, when the shoulder fibers are torn and not functional, the prosthesis provides joint movement and function with the strength of the muscles around the shoulder.
The design logic of the reverse shoulder prosthesis is as follows; the orientation of the shoulder is changed with the reverse shoulder prosthesis. It is the inverse of normal anatomy. In this way, the shoulder working mechanism is changed and the muscles become more functional and advantageous. The patient can move the arm much higher.
How Does the Process Progress After Prosthesis?
For 2 to 4 weeks after prosthetic surgery, the patient must wear a sling to protect and support the shoulder. The stitches will be removed a few weeks after the procedure. Until then, the wound should be protected from water and avoid irritation. Keeping the suture scar bandaged is important in terms of preventing infection.
Most patients can perform simple activities such as eating and dressing within 2 weeks of surgery. Shoulder pain that can be relieved with painkillers is common in the few weeks after surgery. It is recommended not to drive for 2 to 4 weeks after surgery.
Post-operative exercise is a critical point of home care, especially during the first few weeks after surgery. The exercise plan recommended by the surgeon should be followed by a physiotherapist and the muscles should be strengthened again.