Working
at a physical therapy clinic, I do see a great deal of injuries but there are
still many that I have never seen before. One of these being a reverse shoulder
arthroplasty, which involves the tearing of the rotator cuff tendon in the shoulder
due to arthroplasty, which is basically a disease of the joint that leads to
nerve damage and issues of individual joints (Rugg 2019: Barco 2017). This type of rotator
cuff surgery has been utilized in recent years as a new way to treat this
injury. For the surgery, the surgeon will remove the damaged bone and screw in
a metal ball into the shoulder socket and then a plastic cup or opening for the
ball is placed on the upper humerus. This is the reverse of what happens in a
conventional shoulder replacement (Rugg 2019: Barco 2017: Kirzner 2018). Especially people who have no arthritis in
their joints now have a reliable option in what treatment they would like to
undertake. There are different ways that a person can go about their treatment
and it is important that further research is made to uncover what the best
possible treatment is (Kirzner 2018).
This
is especially important because while this type of surgery is very helpful
there are also certain side effects or complications that can occur for some
individuals. The most common complications for this kind of surgery are
infection, nerve damage, fractures of other bones, and possibly misalignment of
the ball and socket (Barco, 2017). However, these issues can all be reduced by having
the surgeon managing tissue damage and paying close attention to how the new
ball and socket interact with each other. Another way to reduce this,
especially in congruence with physical therapy, is meaningful recovery and
rehabilitation. It is not an easy surgery to recover from and it takes time to
heal fully recover. If strengthening and improving flexibility are components
of the treatment it should be a speedy and safe rehabilitation. This was a very
interesting and informative operation that I look forward to learning more
about as I continue my path of being a physical therapist. I do agree that more
research does need to be conducted to produce the best treatment for
individuals with this injury.
Kirzner, N., Paul, E., & Moaveni, A.
(2018). Reverse shoulder arthroplasty vs BIO-RSA: clinical and
radiographic outcomes at short term follow-up. Journal
of orthopaedic surgery and research, 13(1),
256.https://doi.org/10.1186/s13018-018-0955-2
Rugg, C. M., Coughlan, M. J., & Lansdown,
D. A. (2019). Reverse Total Shoulder Arthroplasty: Biomechanics and
Indications. Current reviews in musculoskeletal medicine, 12(4),
542–553. https://doi.org/10.1007/s12178-019-09586-y
Barco, R., Savvidou, O. D., Sperling, J. W., Sanchez-Sotelo,
J., & Cofield, R. H. (2017). Complications in reverse shoulder
arthroplasty. EFORT open reviews, 1(3), 72–80. https://doi.org/10.1302/2058-5241.1.160003
This is an interesting post. I do have a question, how does the success rate of the reverse shoulder arthroplasty compare to the conventional method? Will the use of the reversed method decrease complications?
ReplyDeleteThis is a very interesting read and exciting news for anyone with severe rotator cuff issues. I had no idea that they could synthetically replace the entire ball and socket join if necessary. Any news on if this type of replacement has a timeline on it? I have heard that a hip replacement has a 15 to 20 span of effectiveness and I am curious to see if this procedure has the same. Either way this is a great display of how far we have come with modern medicine and joint replacement techniques. Great Post!
ReplyDeleteAdam, I thought this was a very interesting read. As a person who has experienced a significant shoulder injury, I was told that I was too young for surgery at the time of injury and that I needed to just do extensive PT. This decision may have saved me some time for full range of motion and usage in my youth years, but I am waiting for the day when I will need to get the full replacement. This operation is something that I am definitely going to look into and is an exciting alternative to a usually major surgery. One question I had was how much they clean out the damaged shoulder before they install the "ball" and "cup" device to the humerus/glenoid cavity? Great post.
ReplyDelete