Shoulder resurfacing involves replacing damaged or diseased cartilage and bone of the shoulder joint with artificial implants. The implants are designed to restore function to the shoulder joint.
Compared to a total shoulder replacement where the two bones (humerus and scapula) in the joint are cut and replaced, often only the damaged top (humeral head) of the arm bone is replaced with a metallic artificial head.
A metal ball is attached to the humerus by a short stem or no stem.
The procedure is designed to alleviate shoulder pain and restore a full of range of motion to the shoulder joint and arm. It retains as much normal bone and muscles as possible.
The indications for shoulder resurfacing are similar to shoulder replacement, but it is more often preferred in an individualwith high physical demands and younger age.
Wear and Tear Arthritis (Osteoarthritis)
With this condition the joint surfaces become worn and uneven causing the joint to lose flexibility and develop pain. The surfaces are excised and resurfaced with a smooth metal implant to restore function.
Inflammatory Arthritis (Rheumatoid Arthritis)
Resurfacing will relieve shoulder joint pain and improve functioning caused by the disease, but often the degree of damage will require a total joint replacement.
Humeral Head Necrosis
Also referred to as avascular necrosis, the condition occurs when there is an interruption of blood supply to the bone. The bone of the humeral head then collapses and creates an uneven surface. Resurfacing replacement can be used as the socket or the glenoid side of the joint remains unaffected.
Dislocations or fractures can cause irreparable damage to the joint surface. In severe damage either part or all of the humeral head can be resurfaced to relieve pain and improve functioning.
You will undergo an examination to test the range of movement and strength in the shoulder. The evaluation also ensures you are capable and healthy enough to have surgery and can complete the recovery process successfully.
You may require a number of tests including blood and urine samples, and may also need an electrocardiogram to electronically record the activity of your heart.
X-rays will be conducted to examine the extent of the damage to the shoulder joint and identify the best course of action to take for the surgery.
Advanced MRI imaging may be conducted to thoroughly inspect soft tissue and cartilage.
This form of X-ray imaging enables an accurate three- dimensional model of your shoulder to be determined.
Your orthopaedic surgeon needs to know your medical history and what medications (prescribed and non-prescribed) you are currently taking in order to plan the best treatment. Any and all health problems must be disclosed to avoid issues that may complicate surgery, the anaesthestic process and recovery.
You are put to sleep during the surgery using general anaesthesia and often a regional block of local anaesthetic will be provided for pain relief.
Patients can expect to stay at our hospital for four to five days with a progressive recovery expected anywhere between six weeks to three months.
A sling must be worn for up to six weeks, while sports are to be avoided for at least six months.
An exercise program will be provided by one of our physiotherapists prior to the surgery to restore strength and mobility in the shoulder, and ultimately help with recovery following the procedure.
Your surgeon and physiotherapist will also identify and guide you with what lifestyle changes that are necessary to help protect the joint.
Our patients are advised to return for regular evaluation to monitor progress.
RISKS AND COMPLICATIONS
As with all surgical procedures, shoulder resurfacing does involve some risks. While your surgeon will take every precaution necessary to minimise risk, complications can occur that may have permanent repercussions.
Some specific risks related to shoulder resurfacing include:
- Blood clot
- Blood vessel damage
- Disease progression
- Nerve damage
- Prosthesis wear
This fact sheet is a brief overview of shoulder resurfacing, produced by our Shoulder, Elbow, Wrist and Hand Surgeon Dr Nick Wallwork. To make an appointment or enquiry with Dr Wallwork or one of our upper limb specialists, contact 08 8362 7788 or email firstname.lastname@example.org.