Our Summary

This research paper is about a common surgical treatment for shoulder fractures in elderly people, called Reverse Shoulder Arthroplasty (RSA). The researchers wanted to compare the outcomes of patients who had this surgery right away (acute RSA) versus those who had it after an initial non-surgical or surgical treatment (delayed RSA). They looked at studies of people aged 65 and above.

The research found that patients who had the RSA surgery right away had better range of motion in their shoulders and had higher scores on medical tests that measure shoulder function and health. They also had a lower rate of complications than those who had the surgery later. In other words, getting the RSA surgery right away seemed to have better results than waiting until after other treatments have been tried.

FAQs

  1. What is Reverse Shoulder Arthroplasty (RSA)?
  2. What differences were found between patients who had RSA surgery right away versus those who had it later?
  3. What are the benefits of having RSA surgery immediately after a shoulder fracture?

Doctor’s Tip

A helpful tip a doctor might tell a patient about shoulder replacement is to follow the post-operative rehabilitation plan carefully and consistently. This may include physical therapy exercises, avoiding certain movements or activities, and attending follow-up appointments with the surgeon. By following the rehabilitation plan, the patient can optimize their recovery and improve their shoulder function after surgery.

Suitable For

Typically, patients who are recommended for shoulder replacement surgery are those who have severe shoulder fractures, arthritis, rotator cuff tears, or other conditions that have not responded to non-surgical treatments such as physical therapy, medications, or injections. In particular, elderly patients who are experiencing chronic pain, limited range of motion, and difficulty performing daily activities due to shoulder problems may be recommended for shoulder replacement surgery. Additionally, patients who have failed previous shoulder surgeries or have had recurrent shoulder dislocations may also be candidates for shoulder replacement. It is important for patients to consult with their healthcare provider to determine if shoulder replacement surgery is the right treatment option for their specific condition.

Timeline

Before shoulder replacement surgery:

  1. Patient experiences shoulder pain and limited range of motion.
  2. Patient undergoes tests and evaluations by a healthcare provider to determine the need for surgery.
  3. Patient discusses treatment options with their healthcare provider and decides on shoulder replacement surgery.

After shoulder replacement surgery:

  1. Patient undergoes pre-operative preparations, including physical therapy and medical evaluations.
  2. Patient undergoes the shoulder replacement surgery, which typically lasts a few hours.
  3. Patient stays in the hospital for a few days for recovery and pain management.
  4. Patient undergoes post-operative physical therapy to regain strength and range of motion in the shoulder.
  5. Patient gradually resumes daily activities and experiences improved shoulder function over time.

What to Ask Your Doctor

  1. What is involved in a shoulder replacement surgery?
  2. What are the potential risks and complications associated with shoulder replacement surgery?
  3. What is the expected recovery time and rehabilitation process after shoulder replacement surgery?
  4. How long will the shoulder replacement last and what are the chances of needing a revision surgery in the future?
  5. What are the alternatives to shoulder replacement surgery and why is RSA recommended in this case?
  6. What are the specific benefits of getting the RSA surgery right away versus waiting for other treatments?
  7. How will RSA improve my range of motion and shoulder function compared to other treatment options?
  8. What is the success rate of RSA surgery in elderly patients like myself?
  9. What type of anesthesia will be used during the surgery and what are the possible side effects?
  10. Are there any specific lifestyle changes or activities I should avoid after having a shoulder replacement?

Reference

Authors: Lu V, Jegatheesan V, Patel D, Domos P. Journal: J Shoulder Elbow Surg. 2023 Aug;32(8):1728-1739. doi: 10.1016/j.jse.2023.03.006. Epub 2023 Apr 5. PMID: 37024039