Partial Shoulder Replacement Surgery
From Clinical Update, Fall 2006
After 15 years of shooting high-power rifles in his job as a police department SWAT team member—as well as working as a building contractor in his spare time, Stephen Blemings had developed painful arthritis in his shoulder.
“The pain was so bad I could barely move my arm,” said Blemings, then 39.
Blemings researched treatment options and decided on a partial shoulder replacement to replace only the damaged “ball” portion of his joint and leave the socket intact.
“This procedure allows the native anatomy to be maintained without losing bone,” said orthopaedic surgeon Ethan R. Wiesler, MD. “The implant should last 20 years or more.”
Wiesler said candidates for the procedure are people who have shoulder arthritis involving primarily the ball side of the shoulder joint. The most common reasons for replacing this joint are osteoarthritis, rheumatoid arthritis, severe fractures, or arthritis that develops after a fracture or dislocation of the shoulder. “We’re seeing more and more arthritis in active people and it is becoming more common in young people,” he said.
Shoulder replacement may be an option when the associated pain and mobility problems cannot be managed with medication. With the traditional total replacement surgery, the natural “ball” at the top of the arm bone is removed and a metal implant that is shaped like a half-moon and attached to a stem is inserted down the center of the arm bone. The socket portion of the joint is shaved clean and replaced with a plastic socket that is cemented into the shoulder bone.
For partial shoulder replacement, there are many types of prostheses on the market; the nature of the problem and the needs of the patient determine the type that is used, said Wiesler.
“For patients like Mr. Blemings who are young and active, a special type of partial shoulder replacement called a resurfacing hemiarthroplasty was chosen, as it restores as closely as possible the native shoulder anatomy. This type of partial shoulder replacement requires less bone removal, uses a smaller incision and has a quicker recovery time than ‘standard’ partial and certainly a total joint replacement.”
This resurfacing prosthesis involves placing a metal cap over the damaged “ball” of the upper arm bone. The implant is less complicated to replace if a total shoulder replacement is needed in the future, because it is not attached to the arm with a stem.
Blemings said after surgery he was able to return to all of his activities. “I didn’t miss a beat and don’t have any limitations,” he said.
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