Total Shoulder Replacement

Of the body's joints, the shoulder offers the greatest range of motion, and is important to the majority of both arm and upper body movements. A shoulder injury can result in immense discomfort and pain, as well as an inhibited ability to complete basic activities, such as writing or carrying groceries. Dr. Pritchett offers advanced care options for the diagnosis and treatment of shoulder damage, including the most up-to-date options for shoulder resurfacing surgery. This procedure is an alternative to conventional total shoulder replacement surgery.

Causes of Shoulder Damage

The shoulder is a ball-and-socket joint, and is composed of three primary bones: the humerus, shoulder blade, and collarbone. A combination of articular cartilage and synovial membranes make up a protective coating to the joint's surfaces, offering lubrication for comfortable movements. In addition, a series of muscles and tendons surround the joint to provide strength, stability, and support.

Damage can occur to any and all of the shoulder's components, and is often associated with degenerative disease, progressive wear, or traumatic injury. Osteoarthritis and rheumatoid arthritis significantly impact the cartilage and synovial membranes, respectively, resulting in increased joint friction and discomfort. Other common injuries include rotator cuff tears and fractures, which are most often associated with a specific injury event.

Symptoms and Diagnosis

In cases of degenerative disease or progressive wear, pain and disability will often appear gradually, worsening over time. On the other hand, traumatic injury may result in more immediate and severe symptoms, requiring expedited medical intervention. Regardless of cause, if any of the following symptoms are present, orthopedic attention may be in order:

• Pain that disrupts everyday physical activities
• Discomfort during resting periods
• Decreased range of motion
• Decreased strength and/or feelings of weakness

To identify all contributing factors, an in-depth diagnostic approach will be undertaken by Dr. Pritchett and his team. In addition to recording the patient's medical history and completing basic physical tests, an x-ray, MRI, and/or blood test will likely be completed. Through the insights gathered, an approach for injury correction and rehabilitation will be recommended.

Whenever possible, initial treatment efforts will focus on non-invasive approaches, such as the use of anti-inflammatory and pain medications in conjunction with strength and flexibility exercises. If the symptoms are not responsive, or too severe in initial nature, total shoulder replacement may be recommended.

Shoulder Resurfacing Surgery

Shoulder resurfacing surgery is a complex procedure, which requires a significant degree of personalization for each individual patient. The specific surgical approach taken will depend on the exact areas and types of damage, as well as the patient's overarching body structure. Prosthetics are available in a range of sizes and materials, and may be cemented or "press fit" into place.

During a shoulder resurfacing procedure, Dr. Pritchett and the surgical team will remove the damaged bone and cartilage, maintaining as much of the natural joint structure as possible. Shoulder resurfacing is more conservative, in its preservation of bone, than total shoulder replacement. The different components of the prosthesis will be placed and tested for optimal fit with adjustments made as needed. Once complete, all incisions will be sutured and secured with a protective surgical dressing.

Due to the level of invasiveness required, shoulder resurfacing operations are typically performed on an in-patient basis. The patient will likely be monitored at the hospital or medical facility overnight prior to formal release.

Post-Op Recovery and Rehabilitation

Prior to the resurfacing operation, a comprehensive program for shoulder rehabilitation will be formulated. Immediately following surgery, joint mobility will be prevented for a specified amount of time, allowing for both appropriate healing and the avoidance of prosthesis disruption. In conjunction, anti-inflammatory and pain medications may be utilized to provide immediate relief to any post-op discomfort.

A schedule for resuming everyday activities, as well as incorporating flexibility and strength exercises, will be outlined, and modified in accordance to overarching recovery progress. Both at-home and formal physical therapy will be pursued, ensuring that the joint is recovered in the safest way possible.

As with any operation, there are risks and potential complications associated with shoulder resurfacing surgery. Any concerns should be reported to a healthcare provider immediately.

For the treatment of shoulder pain and disability, Dr. Pritchett will determine if a shoulder resurfacing is required. To schedule an appointment at his office, call (206) 323-1900.