Our Summary

This study looks at a rare condition called chondrolysis, which can result in the rapid breakdown of joints after shoulder surgery. For severe cases, a procedure called shoulder arthroplasty may be considered. However, there are concerns about how long the implants will last, especially given the younger age group usually affected by this condition.

The research involved 26 patients who had developed chondrolysis after shoulder surgery and were treated with shoulder arthroplasty. The patients were tracked for at least 2 years or until they needed another operation. On average, they were tracked for 4 years, and the patients’ average age was 40.

The study measured pain levels, range of motion, and the need for further operations. They found that after the follow-up period, just over half of the patients experienced no or only mild pain. The overall pain scores improved, and the range of motion in abduction and external rotation (lifting the arm to the side and rotating it outward) significantly improved.

However, 5 patients needed another surgery due to various complications, and patients’ satisfaction levels varied. Some patients rated their shoulder as much improved or better, but others said it was the same or worse.

In conclusion, shoulder arthroplasty can improve pain and range of motion for patients with chondrolysis. However, there’s a higher than expected chance (25%) that they’ll need another operation, and patient satisfaction varies. Therefore, patients should be given clear information about what to expect after the surgery.

FAQs

  1. What is chondrolysis and how is it related to shoulder surgery?
  2. What improvements can patients with chondrolysis expect after shoulder arthroplasty?
  3. What is the likelihood of needing an additional operation after shoulder arthroplasty for chondrolysis, and how satisfied are patients with the results?

Doctor’s Tip

One helpful tip a doctor might give to a patient considering shoulder replacement surgery is to carefully weigh the potential benefits and risks of the procedure. It’s important to have realistic expectations about the outcome and understand that there is a possibility of needing additional surgeries in the future. Patients should also be diligent in following their post-operative rehabilitation plan to optimize their recovery and improve their overall outcomes. Additionally, discussing any concerns or questions with their healthcare provider can help ensure they make an informed decision about their treatment.

Suitable For

Typically, patients who are recommended for shoulder replacement surgery include those with severe shoulder arthritis, rotator cuff tears, or fractures that have not healed properly. Patients who have not had success with conservative treatments such as physical therapy, medications, or injections may also be candidates for shoulder replacement. Additionally, patients who have significant pain and limited range of motion in the shoulder that affects their daily activities and quality of life may be recommended for shoulder replacement.

Timeline

Before shoulder replacement:

  1. Patient experiences shoulder pain, stiffness, and limited range of motion.
  2. Patient undergoes various conservative treatments such as physical therapy, medication, and injections.
  3. If conservative treatments fail to provide relief, patient may be recommended for shoulder replacement surgery.

After shoulder replacement:

  1. Patient undergoes shoulder replacement surgery, either total shoulder arthroplasty or reverse shoulder arthroplasty.
  2. Patient undergoes post-operative rehabilitation to regain strength and range of motion in the shoulder.
  3. Patient experiences pain and discomfort in the immediate post-operative period.
  4. Over time, pain levels decrease, and range of motion improves.
  5. Patient may experience complications such as infection, implant loosening, or stiffness, which may require further surgeries.
  6. Patient may need to continue with physical therapy and exercises to maintain shoulder function and prevent complications.
  7. Patient’s overall satisfaction with the surgery varies depending on pain relief and functional improvement.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about shoulder replacement:

  1. What are the potential risks and complications associated with shoulder arthroplasty for chondrolysis?
  2. How long can I expect the shoulder implant to last, especially considering my age?
  3. What is the expected recovery time and rehabilitation process after shoulder replacement surgery?
  4. Will I need physical therapy after the surgery, and if so, for how long?
  5. What are the expected outcomes in terms of pain relief and range of motion improvement?
  6. What are the chances that I may need another surgery in the future?
  7. How will my daily activities be impacted after shoulder arthroplasty?
  8. Are there any specific lifestyle changes I should make to ensure the success of the surgery?
  9. What are my options if I am not satisfied with the results of the surgery?
  10. Are there any alternative treatments or therapies that I should consider before opting for shoulder replacement surgery?

Reference

Authors: Schoch B, Werthel JD, Cofield R, Sanchez-Sotelo J, Sperling JW. Journal: J Shoulder Elbow Surg. 2016 Sep;25(9):1470-6. doi: 10.1016/j.jse.2016.01.005. Epub 2016 Mar 30. PMID: 27038563