Our Summary

This research paper analyzes the effectiveness of shoulder replacement surgery, known as shoulder arthroplasty, in patients suffering from a rare limb deformity and joint disease called osteo-chondrodysplasias. The study followed 13 patients who had shoulder replacement surgery due to severe arthritis caused by this disease.

The study found that the surgery significantly improved pain and movement in the shoulder for the patients. However, the overall success rate varied: only two shoulders were rated as excellent, seven were satisfactory, and four were unsatisfactory. One patient needed to have another surgery due to complications.

Despite this, the research suggests that shoulder replacement surgery can be a beneficial treatment for people with osteo-chondrodysplasias. It also suggests that the risk of needing additional surgeries is lower than previous studies have suggested.

Overall, this study provides valuable insights for doctors considering shoulder replacement surgery for patients with osteo-chondrodysplasias. The results suggest that with the development of smaller implant components, custom implants may not be required, and doctors may be able to intervene earlier and more confidently.

FAQs

  1. What is the effectiveness of shoulder replacement surgery in patients with osteo-chondrodysplasias?
  2. What are the potential risks or complications of shoulder replacement surgery for patients with this rare limb deformity and joint disease?
  3. Does the study suggest that custom implants may be required for shoulder replacement surgery in patients with osteo-chondrodysplasias?

Doctor’s Tip

One helpful tip a doctor might give to a patient considering shoulder replacement surgery is to carefully follow the post-operative rehabilitation plan. This typically involves physical therapy exercises to help regain strength and range of motion in the shoulder. Consistent participation in these exercises can greatly improve the outcome of the surgery and help prevent complications. Additionally, patients should communicate any concerns or changes in symptoms to their healthcare provider to ensure proper healing and recovery.

Suitable For

In general, patients who are recommended for shoulder replacement surgery typically have severe shoulder pain and limited mobility that is not responding to other conservative treatments such as physical therapy, medications, and injections. The most common conditions that may lead to a recommendation for shoulder replacement surgery include:

  1. Osteoarthritis: This is the most common reason for shoulder replacement surgery. Osteoarthritis is a degenerative joint disease that causes the cartilage in the shoulder joint to wear down over time, leading to pain, stiffness, and limited range of motion.

  2. Rheumatoid arthritis: This is an autoimmune disease that causes inflammation in the joints, including the shoulder. Over time, the inflammation can damage the cartilage and bone in the shoulder joint, leading to pain and disability.

  3. Post-traumatic arthritis: This occurs following a severe shoulder injury, such as a fracture or dislocation. The injury can damage the cartilage and lead to arthritis in the joint, causing pain and limited mobility.

  4. Rotator cuff tear arthropathy: This condition occurs when a severe rotator cuff tear leads to arthritis in the shoulder joint. The torn rotator cuff muscles are no longer able to stabilize the joint, leading to pain and limited range of motion.

  5. Avascular necrosis: This condition occurs when the blood supply to the bone in the shoulder joint is disrupted, leading to bone death and collapse. This can cause severe pain and disability in the shoulder.

Overall, patients who are recommended for shoulder replacement surgery typically have significant pain, stiffness, and limited function in the shoulder joint that is impacting their quality of life and daily activities. It is important for patients to discuss the potential risks and benefits of shoulder replacement surgery with their healthcare provider to determine if it is the best treatment option for their specific condition.

Timeline

Before shoulder replacement surgery:

  1. Patient experiences severe arthritis and pain in the shoulder due to osteo-chondrodysplasias.
  2. Patient undergoes a series of conservative treatments such as physical therapy, medication, and corticosteroid injections.
  3. As conservative treatments fail to provide relief, patient and doctor decide on shoulder replacement surgery as the next course of action.

After shoulder replacement surgery:

  1. Patient undergoes the surgical procedure to replace the damaged shoulder joint with an artificial implant.
  2. Patient undergoes post-operative rehabilitation to regain strength and range of motion in the shoulder.
  3. Patient experiences improvement in pain and movement in the shoulder following surgery.
  4. Follow-up appointments with the doctor to monitor the progress and assess the success of the surgery.
  5. Some patients may experience complications or require additional surgeries in the future, but overall, the surgery is found to be beneficial for improving the quality of life for patients with osteo-chondrodysplasias.

What to Ask Your Doctor

Questions a patient should ask their doctor about shoulder replacement surgery include:

  1. What are the potential risks and complications associated with shoulder replacement surgery?
  2. What is the expected recovery time and rehabilitation process after the surgery?
  3. How long can I expect the shoulder replacement to last before needing a revision surgery?
  4. Are there any alternative treatments or therapies that could be considered before opting for shoulder replacement surgery?
  5. What type of implant will be used in the surgery and why is it recommended for my specific condition?
  6. Will I need to make any lifestyle modifications or adjustments after the surgery?
  7. How many shoulder replacement surgeries have you performed, and what is your success rate?
  8. What are the expected outcomes in terms of pain relief and improved function after the surgery?
  9. Will I need any additional treatments or therapies after the surgery to ensure the best possible outcome?
  10. Are there any specific risks or considerations for patients with osteo-chondrodysplasias undergoing shoulder replacement surgery?

Reference

Authors: Schoch B, Werthel JD, Sanchez-Sotelo J, Sperling JW, Cofield RH, Morrey M. Journal: Int Orthop. 2017 Oct;41(10):2129-2134. doi: 10.1007/s00264-017-3588-x. Epub 2017 Aug 7. PMID: 28782076