Our Summary

This study examined the effectiveness of a surgical procedure called reverse total shoulder arthroplasty (RSA) in patients who have arm weakness or paralysis caused by an injury during birth, known as obstetric brachial plexus injury. The researchers tracked the progress of four patients, with an average age of around 49 years old, for a period of about 2 years after they had undergone RSA.

They found that the patients experienced a significant reduction in pain and saw some improvement in their ability to perform everyday activities. However, the patients still had some limitations, particularly in their ability to lift their arms and rotate them externally. This was due to a weakness in the muscles at the back of their shoulder, which have to compensate for the loss of certain movements after the surgery, by retracting the shoulder blade.

In general, the patients reported a better quality of life after the surgery, even with these limitations. This type of study, known as a case series, is an early step in the research process and more studies are needed to confirm these findings.

FAQs

  1. What is reverse total shoulder arthroplasty (RSA)?
  2. What improvements can patients expect after undergoing RSA?
  3. Are there any limitations or potential complications after undergoing RSA?

Doctor’s Tip

One helpful tip a doctor might give a patient about shoulder replacement is to actively participate in physical therapy and rehabilitation exercises following the surgery. This can help improve range of motion, strength, and function in the shoulder joint. Consistent exercise and therapy can also help prevent stiffness and muscle weakness, ultimately leading to a better outcome and quicker recovery. It is important to follow the guidance of your healthcare team and to communicate any concerns or limitations you may have during the recovery process.

Suitable For

Shoulder replacement surgery, including reverse total shoulder arthroplasty, is typically recommended for patients with severe shoulder pain and limited mobility caused by conditions such as osteoarthritis, rheumatoid arthritis, rotator cuff tears, avascular necrosis, or severe fractures. Patients who have failed to find relief with conservative treatments such as physical therapy, medications, and cortisone injections may also be candidates for shoulder replacement surgery. Additionally, patients with certain congenital conditions, such as obstetric brachial plexus injury, may benefit from shoulder replacement surgery to improve function and reduce pain.

Timeline

Before shoulder replacement:

  1. Patient experiences chronic shoulder pain and limited range of motion.
  2. Patient undergoes a series of diagnostic tests such as X-rays, MRIs, and physical examinations to determine the extent of damage to the shoulder joint.
  3. Orthopedic surgeon recommends shoulder replacement surgery as a treatment option.
  4. Patient undergoes pre-operative consultations and medical clearance.
  5. Surgery is scheduled and patient undergoes the procedure.

After shoulder replacement:

  1. Patient goes through a period of post-operative recovery in the hospital, typically lasting a few days.
  2. Physical therapy and rehabilitation exercises are started to help restore strength and range of motion in the shoulder joint.
  3. Patient may experience some pain and discomfort in the weeks following surgery.
  4. Over time, the shoulder gradually heals and the patient begins to regain function in the joint.
  5. Follow-up appointments with the surgeon are scheduled to monitor progress and address any concerns.
  6. Patient continues with physical therapy and exercises to further improve shoulder function.
  7. Patient experiences improved quality of life and ability to perform daily activities with less pain and limitations in shoulder movement.

What to Ask Your Doctor

  1. What is the success rate of reverse total shoulder arthroplasty (RSA) for patients with arm weakness or paralysis caused by obstetric brachial plexus injury?
  2. What are the potential risks and complications associated with RSA surgery?
  3. How long is the recovery process after RSA surgery?
  4. What type of physical therapy or rehabilitation will be recommended after the surgery?
  5. How long can I expect the results of the surgery to last?
  6. Will I need to make any modifications to my daily activities or lifestyle after the surgery?
  7. Are there any alternative treatment options to consider before deciding on shoulder replacement surgery?
  8. How experienced is the surgical team in performing RSA for patients with obstetric brachial plexus injury?
  9. What is the expected timeline for scheduling the surgery and follow-up appointments?
  10. Are there any specific exercises or stretches I should do to help improve my shoulder strength and range of motion after the surgery?

Reference

Authors: Porcellini G, Montemagno M, Manzini C, Fiumana G, Giorgini A, Micheloni G, Tarallo L. Journal: J Orthop Traumatol. 2023 Nov 10;24(1):59. doi: 10.1186/s10195-023-00736-0. PMID: 37947898