Shoulder Hemiarthroplasty
Shoulder hemiarthroplasty is a surgical procedure to repair or replace an injured joint in the shoulder. This procedure is performed using a combination of techniques. The procedure involves an incision that covers a large area of the shoulder and can be performed on patients of any age. The recovery period can take up to two months.
Indications
Shoulder hemiarthroplasty is an option that may be necessary when conservative treatments are inadequate for treating shoulder pain. It may relieve pain or other symptoms, but it carries risks that should be considered before surgery. These include increased risk of stiffness and damage to nerves and blood vessels.
Before shoulder hemiarthroplasty, patients should undergo a series of physical exercises to help strengthen their arm. Rehabilitation of the surgical area is essential to a successful outcome. The patient will be placed under anesthesia during the procedure. They will receive painkillers and ice to control pain. They will also be given antibiotics to prevent infection at the surgical incision site and in the prosthesis. A sling will need to be worn for two to six weeks after surgery. During this time, patients should be able to perform simple tasks with their arm. They will also be given an exercise regimen to complete at home. This program will help speed the recovery process.
Patients with severe proximal humerus fractures can also undergo hemiarthroplasty. Patients who have this procedure will benefit from restoring the head-tuberosity-shaft relationship and will be less likely to experience complications. However, the procedure is not a perfect solution for every patient.
Procedure
Shoulder hemiarthroplasty is a surgical procedure in which the humeral head of the shoulder is replaced with a metal ball and prosthesis. This surgery is performed under general anesthesia. The physician makes an incision in the upper arm and extends the arm to locate the humeral head. The surgeon protects the surrounding muscles and tissue that connects the muscle to bone before cutting it. The humeral head is then replaced with a cap-like prosthesis and the incision is closed with stitches.
After shoulder hemiarthroplasty, patients must stay in a hospital for at least one night. An anesthesia specialist will discuss with the patient the type of anesthesia he or she will receive. The physician may choose to use general or regional anesthesia, which puts the patient to sleep for the entire operation. The surgery usually takes about 2 hours.
The surgeon may also perform a procedure known as a resurfacing hemiarthroplasty. This type of surgery involves a slew of smaller incisions on the shoulder joint. It is most commonly performed in conjunction with humeral joint surface replacement.
Recovery
After shoulder hemiarthroplasty surgery, patients can expect to be in the recovery room for two to three days. The initial phase of recovery involves pain management and the return of passive motion. Physical therapy is necessary to regain strength and range of motion. The physical therapist will teach patients how to perform shoulder exercises.
In a non-prosthetic glenoid arthroplasty (NPGA), the metal ball that articulates with the glenoid bone may cause some initial pain and discomfort, although this should wear out within six weeks. In addition, the healing process can be painful for the first few weeks after shoulder hemiarthroplasty, but pain should gradually subside. Eventually, the patient should experience a comfortable level of discomfort, which will approach the level experienced after a total shoulder arthroplasty.
Recovery from shoulder hemiarthroplasty involves a partnership between the patient and surgeon. Preoperative preparation is essential to ensure that the shoulder will be in the best possible condition for the surgery. For example, patients should stop smoking at least a month before the surgery and not start again until three months after the surgery. They should also be free of any heart conditions or infections, since any underlying disease may cause the surgery to take longer. Additionally, patients should inform their surgeon about any medications they take. For instance, if they take aspirin or other anti-inflammatory drugs, these may alter the body’s ability to clot blood.
Complications
Shoulder hemiarthroplasty is a surgical procedure to replace a portion of the shoulder joint that is damaged by degenerative arthritis. It is indicated for patients with severe or persistent shoulder pain who are not responding to nonoperative treatment. The procedure may reduce pain and symptoms, but it also has risks. These include shoulder stiffness and possible damage to nerves and blood vessels.
The procedure usually takes one to two hours, and the patient will be given general anesthesia. After surgery, the patient will be monitored by X-rays and placed in an immobilizer. Patients should not engage in any vigorous activities for at least one week. Once the shoulder has recovered from surgery, patients should begin passive exercises to strengthen the joint and minimize the risk of complications.
The authors found that shoulder hemiarthroplasty is associated with significant risks of infection and complication. The study included 485 patients who underwent shoulder arthroplasties. A total of 56 patients experienced a complication. Of these, 34 were category 1 complications while 11 were category 2 complications. Overall, the complication rate was 11.6%, which is comparable with other reported complication rates.
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