Our Summary

This research paper is about a type of shoulder injury called a “locked shoulder dislocation.” This happens when the top part of the arm bone gets stuck in an unnatural position in the shoulder blade. These injuries are rare and can be hard to diagnose, often leading to significant issues with shoulder function.

Doctors aren’t completely sure of the best way to treat these injuries as they don’t occur very often. The researchers carried out a review of previous studies to try and work out the best treatment approach. They focused on the results of surgeries called arthroplasties, where the damaged part of the shoulder is replaced with an artificial part.

The study found that a type of surgery called total shoulder arthroplasty (TSA), where the entire shoulder joint is replaced, can significantly reduce pain. This type of surgery also seemed to work better in older patients, leading to better results and higher patient satisfaction compared to younger patients.

The study also found that the longer the dislocation went untreated, the more likely it was that further surgery would be needed after the initial operation. The researchers also looked at the rate of complications and the need for further surgery after the initial operation but found no significant differences.

Overall, the data suggests that both types of surgery can effectively treat locked shoulder dislocations. However, the paper suggests that TSA may be a better option, especially for older patients, and that early diagnosis and treatment can lead to fewer complications and less need for further surgery. The role of another type of surgery, reverse shoulder arthroplasty, is still unclear as there isn’t enough data on its effectiveness.

FAQs

  1. What is a “locked shoulder dislocation” and how common is it?
  2. What is total shoulder arthroplasty (TSA) and how effective is it in treating locked shoulder dislocations?
  3. Does the delay in treatment of a locked shoulder dislocation impact the need for further surgery?

Doctor’s Tip

A helpful tip a doctor might give a patient about shoulder replacement surgery for a locked shoulder dislocation is to follow a strict rehabilitation program post-surgery. This may include physical therapy exercises to strengthen the shoulder muscles, improve range of motion, and prevent stiffness. It is important for patients to be patient with the recovery process and follow their doctor’s instructions closely to ensure the best possible outcome. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support the healing process and prevent future shoulder issues.

Suitable For

Patients who are typically recommended shoulder replacement surgery for locked shoulder dislocations include older patients who are experiencing significant pain and limited function in the shoulder joint. These patients may have tried other treatments such as physical therapy or medications with little success. Additionally, patients who have had a locked shoulder dislocation for an extended period of time may also be recommended for shoulder replacement surgery to prevent further complications and improve overall shoulder function. It is important for patients to consult with their healthcare provider to determine the best treatment approach for their specific situation.

Timeline

Before shoulder replacement surgery:

  1. Patient experiences pain, stiffness, and limited range of motion in the shoulder.
  2. Patient undergoes imaging tests such as X-rays and MRI to diagnose the extent of the shoulder injury.
  3. Patient may try non-surgical treatments such as physical therapy, medications, and injections to manage symptoms.
  4. If non-surgical treatments are ineffective, patient and their doctor may decide on shoulder replacement surgery.

After shoulder replacement surgery:

  1. Patient undergoes the surgical procedure, either total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty, to replace the damaged part of the shoulder.
  2. Patient undergoes post-operative rehabilitation to regain strength, mobility, and function in the shoulder.
  3. Patient may experience pain and discomfort immediately after surgery, which gradually improves with time.
  4. Patient gradually resumes normal activities and may require follow-up appointments with their surgeon to monitor progress and address any concerns.
  5. Over time, patient experiences improved shoulder function, reduced pain, and increased overall quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about shoulder replacement for a locked shoulder dislocation include:

  1. What are the different types of shoulder replacement surgeries available for treating a locked shoulder dislocation?
  2. What are the potential risks and complications associated with shoulder replacement surgery?
  3. How long is the recovery process after shoulder replacement surgery?
  4. What are the expected outcomes and success rates of shoulder replacement surgery for locked shoulder dislocations?
  5. Are there any alternative treatments or therapies that could be considered before opting for surgery?
  6. How long do the results of shoulder replacement surgery typically last?
  7. What is the expected level of pain relief and improvement in shoulder function after surgery?
  8. Are there any specific rehabilitation exercises or physical therapy that will be necessary after shoulder replacement surgery?
  9. How often will follow-up appointments be needed after surgery, and what signs of complications should I watch out for?
  10. What is the experience and success rate of the surgeon in performing shoulder replacement surgeries for locked shoulder dislocations?

Reference

Authors: Crowley M, Ghattas Y, Collins AP, Levin S, Service BC. Journal: Orthop Surg. 2023 Jul;15(7):1730-1741. doi: 10.1111/os.13758. Epub 2023 Jun 1. PMID: 37259941