Orthopedic Shoulder Replacement is a procedure where the entire shoulder joint it replaced with a new ball and socket shoulder joint, it is a complex procedure and requires advanced surgical skills and expertise to achieve a good, near complete native shoulder function without complication.
Shoulder replacement are categorised as primary shoulder replacement, which means the patient undergoes shoulder replacement surgery for the first time. This can be of two type -
Another type of shoulder replacement is called reverse total shoulder replacement.
A Reverse total shoulder replacement is used for people who have severe arm weakness or have severe arthritis and rotator cuff tearing. In these cases an anatomical (conventional) total shoulder replacement can still leave them with pain.
They may also be unable to lift their arm up past a 90-degree angle and this can be severely debilitating.
In reverse total shoulder replacement, the socket and metal ball are switched. That means a metal ball is attached to the socket bone (glenoid) and a plastic socket is attached to the humerus head (ball).
This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.
The surgeon needs to assess the shoulder in detail before consideration of reverse total shoulder replacement.
A reverse total shoulder arthroplasty, or TSA, refers to a similar procedure in which the prosthetic ball and socket that make up the joint are reversed to treat certain complex shoulder problems. TSA involves a stemmed-humeral component containing a polyethylene humerosocket replacing the humeral head, and a highly polished metal ball known as a glenosphere replacing the socket, or glenoid. One can think of this as the “ball and socket” components being switched. This allows for better fixation of the prosthetic parts and increased stability of the joint. An TSA currently is indicated for patients suffering from osteoarthritis or compound fractures of the humerus, in conjunction with a deficiency of the rotator cuff complex. Matsen et al. also states that an TSA should be considered for patients whose shoulder problems cannot be managed using a conventional TSA. Several features make the TSA more compatible for certain patient populations. The deep concavity of the humeral articular component, as well as the simplicity of the glenoid component, allow for better fixation of the prosthesis and fewer problems with component loosening. Compensation for rotator cuff dysfunction is made with the TSA that typically is left unmanaged in conventional TSA. Several long term studies have been done on the procedure with positive results. Early studies found both high complication and revision rates, 50% and 60% respectively, however a 2007 retrospective study by Wall et al. found a complication rate of only 19%. The authors of this study also suggest that TSA can be used for a larger population of patients receiving a shoulder replacement, not just those with rotator cuff arthropathy. Early evidence suggests that TSA is a viable option for certain patient populations with more research needed in comparisons with TSA and Hemiarthroplasty.
Total shoulder arthroplasty, or TSA, is a procedure used to replace the diseased or damaged ball and socket joint of the shoulder with a prosthesis made of polyethylene and metal components. In TSA, the current components of the glenoid are either a pegged or keeled high-molecular weight polyethylene cemented component. These become fixated by allowing bony ingrowth through the pourous ends of the component. For some shoulders with inferior bone quality, metal backing is used to increase the durability and fixation of the polyethylene component. Controversy still exists as to the stress effects metal backing can potentially cause on the joint.
The humeral component consists of the artificial metal humeral head attached to a metaphyseal stem that is either fully cemented, proximally cemented, of press-fit into the humeral shaft. Harris et al. Found no difference in comparing micromotion between fully and proximally cemented techniques.
Indications for TSA include: osteoarthritis, inflammatory arthritis, osteonecrosis involving the glenoid, and posttraumatic degenerative joint disease. The patient must also have an intact rotator cuff complex, or else other prosthetic techniques would be implicated. A prospective study by Barrett et al. found that 47 or 50 patients treated with TSA had significant decreases in pain and increases in range of motion compared to presurgical measurements. A 2004 study by Collins et al. compared conventional TSA with Hemiarthroplasty and although both groups showed significant decreases in pain from pretreatment measurements, the TSA group demonstrated more increases in ROM.
Dr. Omkar is excellent Doctor. My 11 year old son fallen down while playing with both fracture wrist. Left hand wrist operation was so critical and 2-3 Doctors refused to do this operation but Dr. Omkar has given us hope and started the operation immediately after admitted my son at the SRV Hospital-Chembur. His study, observation and experience is too good. He is also a very helpful person as human being.
Dr. Omkar Sadigale is very knowledgeable. He diagnosed my wife’s ankle fracture correctly which other doctors could not do. He follows full ethical practices so you are assured that you are in safe hands. I would highly recommend Dr. Omkar Sadigale for any orthopedic or bone surgery related needs.
Best doctor I ever came across! SRV hospital rocks only because they have Dr. Omkar in their hospital as the best orthopedic!! Excellent guidance throughout and for any issues just a call away be it whatever time day or time blessed to have such Dr's whom we trust with our treatments and they don't let us down!
I had a toe fracture as I fell while parking my two wheeler. I was immediately taken to SRV hospital, Chembur under the care and treatment of doctor Omkar Sadigale. Thereafter everything was well handled and taken care by dr.Omkar. There was a small operation conducted on my toe to realign the fractured bones. Now I am fine and able to walk. He is one of the best orthopaedic in Mumbai.
My son has got hip and shoulder fractures due to conversion. I admitted him to SRV Chembur due to RTPCR positive. To be great humanity Dr. Omkar was there at that time in hospital. When I met him at that time I had confidence that I am at the right place. He checked my son and carried operation on the same day afternoon. during the operation, he boosts my morale...Read More
