|ARTHRITIS OF THE SHOULDER
There are 2 bony articulations or joints in the shoulder complex where osteoarthritis can occur.
a) The glenohumeral articulation between the humerus and the glenoid
THE HEAD OF THE HUMERUS HAS BECOME FLATTENED BY DEGENERATIVE CHANGES
The inflammatory condition rheumatoid arthritis affects multiple joints, the shoulder being one of them.
THIS X RAY SHOWS EXTREME WEAR FROM CHANGES RELATED TO RHEUMATOID ARTHRITIS TO THE EXTENT THAT THE HUMERAL HEAD HAS FRACTURED
Signs and Symptoms
• Pain aggravated by activity, typically felt deep or behind the shoulder in cases of glenohumeral arthritis and in the front for acromioclavicular arthritis.
• Change of activities to avoid provoking symptoms.
LINK TO TSR SURG AND ‘OXFORD’ WHAT TO EXPECT FROM TSA
The purpose of this operation is to replace the articular surfaces of the humeral head and glenoid with prosthetic implants, to control pain and improve function.
All patients with pain from arthritis of the glenohumeral joint.and a rottor cuff that is intact.
Copy TSR with RCR
A Deltopectoral approach is used
Possible Associated Procedures
Main Possible Complications
After your operation
-The arm will be rested in a controlled position in a sling or brace. The physiotherapist and nursing staff will show you how to adjust and safely remove and re-apply this.( link to living with a sling)
TOTAL SHOULDER REPLACEMENT WITH ROTATOR CUFF REPAIR
Patients with pain from arthrosis or degenerative changes of the glenohumeral (shoulder ) joint with an additional,repairable Rotator Cuff tear.
Two implants are used; a humeral component, composed of a modular metal shaft with separate head components and a glenoid component made of polyethylene with or without a metal surface.
A deltopectoral incision is used .
- Acromioplasty. This may be needed with sub acromial decompression if sub acromial impingement co-exists
Main Possible Complications
-You will be able to return home when when your pain is well controlled and you can cope with your arm in the sling. This is typically 2 days after surgery.
-You can expect to need painkillers for 2 to 3 weeks after surgery to control any background pain. You will also need to take painkillers an hour before each exercise / physiotherapy session. You will need to do exercises for at least 8 weeks after surgery.
-You will be shown specific shoulder and arm exercises by your physiotherapist before you leave the hospital. These exercises are evry important and must be carried out accurately after leaving hospital on a daily basis at home: ideally 3 times a day.
-The stitches must be removed or the wound inspected ( if absorbable sutures are used) at 14 days after surgery: either by your GP’s practice nurse or at the hospital.