II. Definitions
- Glenoid and humeral head replacement
III. Indications
- Severe Shoulder Osteoarthritis
- Shoulder Pain and loss of function refractory to conservative therapy or prior surgery
- End-stage rotator cuff Arthropathy
- Osteonecrosis
IV. Contraindications
- Recent infection
- Neuropathic joint
- Deltoid or rotator cuff complete paralysis
- Debilitating comorbid illness
- Shoulder Instability that cannot be surgically corrected
V. Efficacy
- Most effective and long-lasting procedure for severe Shoulder Arthritis
VI. Procedure: General
- Arthoplasty performed under general Anesthesia with supplemental Regional Anesthesia in some cases
- Minimal blood loss
VII. Procedure: Traditional Total Shoulder Total Shoulder
- Glenoid fossa resurfaced with solid polyethylene part
- Humeral head and neck replaced with metal prosthesis
VIII. Procedure: Reverse Total Shoulder Arthroplasty
- Ball is attached to glenoid and socket to the proximal Humerus (reverses anatomic positions)
- Function after reverse arthroplasty may be better than traditional replacement in specific cases
-
Shoulder Dislocations may occur in 4% of patients (esp. Obesity, prior dislocation)
- May occur within weeks of surgery (most common)
- Delayed dislocation may be due to glenoid bone loss, implant wear, malalignment
- Risk of neurovascular injury (esp. Axillary Nerve Injury)
- Use standard Shoulder reduction techniques if not contraindicated
- Refer to orthopedics after reduction (revision may be needed in up to 45% of cases)
- Defer reduction to orthopedics in complicated cases
- References
- Riveros (2024) Crit Dec Emerg Med 38(12): 20-1
IX. Protocol: Post-operative Management
- Sling used for 3-6 weeks after surgery
- Post-operative rehabilitation
- Day 1
- Start active range of motion of elbow, wrist and hand
- Start passive range of motion of Shoulder
- Day 21
- Start pulley Exercises
- Day 35
- Start Isometric Exercises
- Day 1
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Related Studies
Concepts | Therapeutic or Preventive Procedure (T061) |
SnomedCT | 308681004, 8020008 |
Dutch | schouderverplaatsing |
German | Schulterersatz |
Italian | Sostituzione della spalla |
Portuguese | Substituição do ombro |
Spanish | Sustitución del hombro, artroplastia de hombro con prótesis, artroplastia protésica del hombro (procedimiento), artroplastia de hombro con prótesis (procedimiento), artroplastia protésica del hombro, artroplastia de hombro con prótesis articular sintética, artroplastia de hombro con prótesis articular sintética (procedimiento), artroplastia del hombro con prótesis articular sintética (procedimiento), artroplastia del hombro con prótesis articular sintética, reemplazo de hombro |
Japanese | 肩関節置換, カタカンセツチカン |
French | Remplacement de l'épaule |
English | Prosthet arthroplasty shoulder, replacement shoulder, replacements shoulder, shoulder replacement, Shoulder replacement, Prosthetic arthroplasty of the shoulder, Prosthetic arthroplasty of the shoulder (procedure), Arthroplasty of shoulder with synthetic joint prosthesis (procedure), Arthroplasty of shoulder with synthetic joint prosthesis, Arthroplasty of shoulder with synthetic joint prosthesis, NOS |
Czech | Náhrada ramenního kloubu |
Hungarian | Vállízület pótlás |
Ontology: Total shoulder replacement (C0186657)
Concepts | Therapeutic or Preventive Procedure (T061) |
ICD10 | 48918-00 |
SnomedCT | 150154008, 42262007 |
English | Prosth total arthropl shoulder, TSR - Total shoulder replacemt, shoulder arthroplasty total shoulder replacement, shoulder arthroplasty total shoulder replacement (treatment), total shoulder replacement, Total arthroplasty of shoulder, total shoulder arthroplasty, replacements shoulder total, Prosthetic total arthroplasty of the shoulder (procedure), Total shoulder replacement, Prosthetic total arthroplasty of the shoulder, TSR - Total shoulder replacement, Total shoulder replacement (procedure) |
Spanish | reemplazo total de la articulación del hombro, reemplazo total de la articulación escapulohumeral (procedimiento), reemplazo total de la articulación escapulohumeral |
Ontology: Arthroplasty of the shoulder (procedure) (C0186662)
Concepts | Therapeutic or Preventive Procedure (T061) |
ICD10 | U004741 |
SnomedCT | 150153002, 119636002, 86784007, 239468007, 217225009 |
Italian | Artroplastica della spalla |
Japanese | 肩関節形成, カタカンセツケイセイ |
English | Arthroplasty of the shoulder (procedure), shoulder repair (treatment), shoulder arthroplasty (treatment), shoulder repair, shoulder arthroplasty, repair shoulder, Shoulder: Repair, Shoulder arthroplasty, Arthroplasty of shoulder (procedure), Shoulder repair (procedure), Arthroplasty of the shoulder, Repair of shoulder, Repair of shoulder (procedure), Arthroplasty of shoulder, Shoulder repair, Arthroplasty of shoulder, NOS, Repair of shoulder, NOS, Arthroplasty of shoulder (procedure) [Ambiguous] |
Czech | Umělá náhrada ramenního kloubu |
Hungarian | Váll arthroplastica |
Spanish | artroplastia del hombro (procedimiento), reparación del hombro, artroplastia de la articulación escapulohumeral, reparación de la articulación escapulohumeral (procedimiento), artroplastia de hombro, artroplastia de la articulación del hombro, artroplastia de hombro (procedimiento), reparación de la articulación escapulohumeral, artroplastia de la articulación escapulohumeral (procedimiento), reparación quirúrgica del hombro, artroplastia del hombro, artroplastia de la articulación escapulohumeral (concepto no activo), reparación de hombro (procedimiento), reparación de hombro, Artroplastia del hombro |
Portuguese | Artroplastia do ombro |
Dutch | schouderartroplastiek |
French | Arthroplastie de l'épaule |
German | Schultergelenksplastik |