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Shoulder Joint Replacement (SJR)

Synonyms: Shoulder Replacement, Shoulder Arthroplasty

What is Shoulder Joint Replacement?

Shoulder Joint Replacement is a procedure in which the diseased and damaged parts of your shoulder joint are removed surgically and replaced by an artificial joint or a prosthetic joint. The artificial joint parts are made of plastic or metal and function just like a normal, healthy joint. The artificial shoulder joint comprises of 3 parts: The humeral component (metal) which is implanted in the humerus, the humeral head component (metal) which replaces the humeral head at the top of the humerus and the glenoid component (plastic) which replaces the surface of the glenoid socket. There are 2 types of surgical procedures for Shoulder Joint Replacement: Total Shoulder Joint Replacement - In this procedure all the three components of the shoulder joint are replaced; Partial Shoulder Joint Replacement - In this procedure, 2 components of the shoulder joint i.e. the humeral component and the humeral head are replaced.

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Where can I get Shoulder Joint Replacement?

Country Cost with MedSolution
Poland (inquire)
Cost of procedure performed in the US: $20,000 to $25,000.
All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

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Who is an ideal candidate for Shoulder Joint Replacement?

If you have osteoarthritis or rheumatoid arthritis of the shoulder which has failed all conservative treatments like anti-inflammatory medications and physiotherapy or if you have damage to the shoulder joint components due to injury or trauma, then you are an ideal candidate for Shoulder Joint Replacement surgery.

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What does a Shoulder Joint Replacement involve?

General anesthesia is used most commonly during Shoulder Joint Replacement surgery. The incision is 3 - 4 inches long and is made on the front of the shoulder from the collarbone (clavicle) to the point where the shoulder muscle (deltoid) attaches to the upper arm bone. This area of your arm is rich in nerves and blood vessels and your surgeon will have to be very careful while performing the procedure of Shoulder Joint Replacement. Your upper arm bone (humerus) will be dislocated from the socket to expose the ball-like end of your upper arm. The portion of your bone covered by articular cartilage is removed. The cavity of your joint will be cleaned and enlarged to create a hollow that matches the shape and size of the implant stem. The head or the rounded surface of the humerus will be cleaned and an appropriate size of the artificial ball will be selected and attached. If the socket is damaged, your surgeon will implant the glenoid component as well to replace the socket during Shoulder Joint Replacement. The surgeon prepares the socket surface by removing the remaining damaged cartilage. The plastic component is then fitted into the socket surface and cemented into position. Your surgeon reattaches the supporting tendons and closes the incision. Your arm will be placed in a sling and a support pillow will be placed under the elbow to protect the repair. A drainage tube will be inserted to remove excess fluids. The drainage tube will be removed on the next day of the Shoulder Joint Replacement surgery. The Shoulder Joint Replacement surgery may last any where from 3 - 4 hours.

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How do I prepare for the Shoulder Joint Replacement?

Shoulder Joint Replacement surgery is usually scheduled in advance unless it is an emergency. Consult your physician about discontinuing all anti-inflammatory medications including aspirin a week before your Shoulder Joint Replacement surgery. Inform your physician about all the prescription and non-prescription medications (including vitamin, mineral and herbal supplements) that you are taking. Talk to your physician and learn what to expect before, during and after Shoulder Joint Replacement surgery. A number of routine pre-operative screening tests like blood tests, ECG, x-ray of chest and shoulder joint, MRI, physical examination and an examination by your anesthesiologist and orthopedic surgeon will be performed one week prior to the Shoulder Joint Replacement surgery. You will be advised to check in to the hospital evening before the Shoulder Joint Replacement surgery. You will be advised not to eat or drink any thing at least 12 hours prior to Shoulder Joint Replacement surgery.

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What to expect during the recovery period of Shoulder Joint Replacement?

A carefully planned rehabilitation program customized to to your individual needs is very critical for quick and successful recovery following Shoulder Joint Replacement surgery. Physical therapy will be initiated in the next few hours after the Shoulder Joint Replacement surgery. Physical therapy will consist of passive-assisted exercises for the range of motion at the shoulder joint. Your therapist will train you on how to use the pulley device to help bend and extend your arm. Wear a sling all the time for at least one month after the Shoulder Joint Replacement surgery. Bring loose fitting clothing which will make it easier for you to change and dress yourself. Complete recovery of range of motion (depending on how stiff your shoulder joint was) before the Shoulder Joint Replacement surgery returns in 2 - 3 months. Formal physiotherapy and occupational therapy may be required for the first 6 weeks after the Shoulder Joint Replacement surgery. After that, your rehabilitation program can continue at home. You may need to do these exercises several times a day for the next 4 - 6 weeks after the Shoulder Joint Replacement surgery.

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What is the outcome of Shoulder Joint Replacement?

It is difficult to predict how long an artificial shoulder will last following the Shoulder Joint Replacement surgery. However, this depends on several factors including your age, activity level and bone strength. A successful outcome to your Shoulder Joint Replacement surgery largely depends on the commitment with which you perform your exercises. Through the well thought out customized rehabilitation program, your muscles will be methodically and progressively stretched and strengthened over one year's time. The ideal outcome is regaining optimum function of your new shoulder joint following the Shoulder Joint Replacement surgery.

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B . R . A . N . D . of Shoulder Joint Replacement

Benefits of Shoulder Joint Replacement

  • There is improvement in the quality of life following Shoulder Joint Replacement surgery. Shoulder Joint Replacement surgery is extremely beneficial if you suffer from severe form of shoulder arthritis or shoulder joint injury that may cause necrosis (death) of surrounding muscles and tissues.
  • Shoulder Joint Replacement typically provides relief of shoulder pain and restoration of movements at the shoulder joint.

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Risks of Shoulder Joint Replacement

  • Infection of the implant - this may require a revision procedure.
  • Damage to the nerves or blood vessels in the surrounding area.
  • Pulmonary embolism
  • Fracture - The upper arm bone may get fractured during or after Shoulder Joint Replacement surgery.
  • Loosening of the artificial joint - This is a very common complication following Shoulder Joint Replacement surgery due to bone loss or failure of Shoulder Joint Replacement procedure.

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Alternatives to Shoulder Joint Replacement

  • Physical Therapy - Exercises to strengthen the muscles around the shoulder may decrease the strain on the shoulder and prevent wearing out of muscles around the shoulder joint.
  • Pain medication - Prescription and over-the-counter medications such as NSAIDs (non-steroidal anti-inflammatory medications) play a very important role in alleviating pain and inflammation especially during the waiting period before Shoulder Joint Replacement surgery.
  • Intra-articular injections - Injecting cortisone in the joint space provides temporary relief of pain and inflammation
  • Activity modification - Restricting or modifying certain activities can also be helpful.
  • Shoulder Arthroscopy - This method of treatment for shoulder arthritis is still debatable.

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Now or Never

  • Modern and sophisticated advances in surgical techniques have minimized the risks of intra-operative or post-operative complications of Shoulder Joint Replacement to miniscule levels. However, it is extremely crucial to discuss the pros and cons of this surgery with your orthopedic surgeon to be able to make an informed decision.

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Decision to have Shoulder Joint Replacement

The bottom line - final decision is yours. You do not have to live with pain and limitation of shoulder movement to restrict your daily and leisure activities that you enjoy. However, also keep in mind that Shoulder Joint Replacement surgery will not allow you to indulge in activities that you could not perform before the surgery. The ultimate goal is to be comfortable, independent and pain free.

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Keywords: Bones & Joints, Arthritis, Joint Pain, Artificial Joints, Osteoarthritis of the Shoulder, Rheumatoid Arthritis of the Shoulder, Osteotomy, Degenerative Joint Disease, Shoulder Arthroscopy, Intra-articular Injections, Osteomyelitis, Rehabilitation Therapy, Physical Therapy, Occupational Therapy

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