No advice from friends on total shoulder replacement surgery

July 19th — admin

When I had my knee replaced many of my friends had already had this same operation. They gave me lots of advice and information. Now I’m getting ready for a shoulder replacement. I can’t find even one friend or relative who’s had this surgery. Are folks who have this done happy with the results?

It’s true that the number of hip and knee replacements far out pace the number of shoulder replacements. The number of shoulder replacements is increasing every year. Last year more than 10,000 were done in the United States.

Long-term studies 20 years down the road aren’t available yet. But short- to mid-term results are in. Most patients have a good result with decreased pain and improved movement. These two results also mean better function and higher quality of life for most people.

As with any surgery, problems can occur. In a small number of patients blood clots, infection, or fracture can cause death or delay recovery. The risk of technical difficulties is greater with shoulder replacement surgery compared to hip and knee.

Overall, patients report improved quality-of-life with a shoulder replacement. If they had to do it over again, they would have the same operation.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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When to cross over from partial shoulder replacement to total shoulder replacement

July 6th — admin

I had a partial shoulder replacement six months ago and I’m not happy with the results. My shoulder is stiff, sore, and painful all the time. It’s worse than before the operation. I’m ready to just go for a total shoulder replacement. What do you advise?

About 20 percent of the patients who have a partial replacement or hemiarthroplasty cross over to a total shoulder arthroplasty (TSA). Pain and stiffness are the reasons given most often for the conversion.

Most patients cross over after having the hemiarthroplasty two years. A few patients have converted as early as 12 months. Most surgeons would advise continued rehab between six and 12 months. Bone healing can take a full year.

Muscle and joint stiffness is common with aging and can make for a longer rehab process. Review all other risk factors. Eliminate all possible causes of slow healing such as tobacco use, inactivity, or poor control if you have diabetes. Nutrition can also play a key role in healing.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Partial vs. total shoulder replacement

June 25th — admin

I have severe pain and limited motion in my left shoulder. My problems all come from arthritis. My doctor thinks I should have a partial shoulder replacement. If the arthritis gets worse I can always have a total replacement later. Does it really work that way?
Many doctors hold to this idea. A recent review of the studies on partial (hemiarthroplasty) versus total shoulder replacements might call that plan into question.

Some studies show that even with a hemiarthroplasty the surface of the shoulder socket continues to wear down and deteriorate. Then when it’s time to convert to a total shoulder, there isn’t enough good, solid bone for the implant.

On the other hand, starting with a total shoulder arthroplasty (TSA) leaves the patient with no place to go if problems occur. There isn’t a good replacement for the replacement.

Overall the studies done comparing hemiarthroplasty to a TSA show the TSA gives patients better function over a longer period of time. More studies are needed to fully compare these two treatment options.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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What causes total shoulder replacement to fail?

June 9th — admin

Two years ago, I had a total shoulder replacement. Now, I have painful clicking and popping in that shoulder. The doctor thinks I have a failed replacement. What could have caused this to happen?

In about one-third of all cases, implant failure occurs after some kind of trauma. In other patients, bone loss contributes to joint failure. This may occur as a combination of decreased bone density from osteoporosis and bone removal during the operation.

A recent study at the Mayo Clinic reports results after shoulder replacement. Failures were often caused by more than one factor. Muscle tears, improper position of the implant, and tension in the joint capsule were all listed as possible causes. Soft-tissue imbalance was present in all cases.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Time for total shoulder replacement? Not so fast!

June 4th — admin

I have arthritis in my left shoulder. It hurts constantly, but I can use it for most things. How can you tell when it’s time for a shoulder replacement?

The first place to start is with a medical exam. An orthopedic doctor is the specialist to see for this kind of problem. In some cases, medications and exercise may be all that’s needed. Muscle weakness can cause pain. A good rehab program can reduce pain, improve motion, and increase strength.

Sometimes, surgery to repair a torn tendon or muscle is advised. Many patients with shoulder pain have undiagnosed soft tissue damage. This could have happened years ago after a fall or other injury. A total joint replacement isn’t always the first answer to shoulder problems.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Which test is best to show torn rotator cuff?

May 11th — admin

Is it possible to have a normal tendon show up as torn on an ultrasound study? I just had an MRI and an ultrasound. The MRI was normal but the US showed a tear in my rotator cuff. Which test should I believe?

Depend on your doctor’s final word to guide you. Doctors rarely rely on imaging studies without knowing the patient’s history and doing an exam. Many clinical tests can be done to find the exact tendon that’s involved.

A misdiagnosed torn rotator cuff usually goes the other way. In other words, there’s a tear but the image shows a normal tendon. It would be rare (but possible) to have a normal tendon diagnosed as torn. This could occur when there is what’s called an artifact, a blip in the picture. Artifacts come from extra electronic signals. Another possible reason for a wrong diagnosis is that the radiologist looking at the image can misread it.

One benefit to in-office ultrasound testing for orthopedic surgeons is the doctor’s knowledge of the patient. The patient doesn’t have to depend on the results read by a radiologist who has never seen the patient.

The surgeon has the advantage when looking at the image of knowing how the patient presented. The test can be done at the time of the exam, saving the patient from having to make another appointment on another day.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Shoulder surgery complications perhaps caused by fluid

May 6th — admin

My father-in-law had surgery on his shoulder to repair a torn rotator cuff. Afterwards he had a lot of swelling on the back of his neck down into the back of his shoulder. What could cause this problem?

Swelling of the neck, nerve problems, and even death of skin tissue can occur after arthroscopic surgery. Evidently the surgeon pushes fluid into the joint during the operation. This helps keep the joint open. It also washes away any blood that might keep the surgeon from seeing what he or she is doing.

The longer the surgery takes, the more fluid is forced into the joint. This increases the chances of problems occurring. Surgeons are encouraged to shorten the operating time as much as possible to reduce the amount of fluid put into the joint.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Could shoulder surgery cause weight gain?

May 3rd — admin

Whoa! I had arthroscopic surgery on my shoulder yesterday. Home today. I jumped on the bathroom scale and I’ve gained 10 pounds. I wasn’t even in the hospital overnight. Is this from the operation? What’s going on?

You aren’t the first one to have scale shock after shoulder arthroscopy. Most folks notice between a two and 20-pound weight gain. The average weight gain is about 10 pounds.

A recent study from the University of Texas tracked weight change in patients before and after this surgery. They found the main cause was the fluid pushed into the joint to help separate the joint surfaces. It gives the surgeon a little more room to work in.

The more damage there is to the joint or the longer the surgery takes to finish, the more fluid is pushed into the area. This is the key factor causing the weight gain. Doctors have been advised to shorten the surgical time whenever possible.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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How late is too late to treat rotator cuff tear?

April 22nd — admin

Years ago, I tore my rotator cuff while lifting and carrying children in a daycare. I couldn’t take time off from work for physical therapy or surgery then. Now, I have chronic pain that’s worse at night. Is it too late for treatment?

Maybe not. Untreated rotator cuff tears can lead to wear and tear on the shoulder joint. A chronic tear with arthritis often results in restricted and sore shoulder motions. Severe pain is reported with daily activities and at night.

Doctors offer several methods of treatment for this problem. The joint can be cleaned out, fused, or replaced. Removing fragments of tissue, scraping off bone spurs, and opening the joint space can help. Fusion eliminates pain, but also restricts motion.

Replacing the joint is a third option. One or both sides of the joint is removed and replaced. If both sides are involved, it’s called a total joint arthroplasty. If only one side is altered, it’s a hemiarthroplasty.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Shoulder can dislocate even after surgery

April 20th — admin

I have a chronic dislocating shoulder that needs fixing. The doctor told me there’s still a 25 percent chance the joint can dislocate again even after repair. Why is that?

Studies show that shoulder dislocation after repair occurs anywhere from 12 to 24 percent of the time. There are different reasons for this. Sometimes it depends on the type of surgery done to repair the problem.

For example, an open incision allows the surgeon to repair the tear in the cartilage and tighten up the joint capsule at the same time. Arthroscopic surgery may only include repair of the damaged soft tissue while leaving the capsular laxity alone.

Another factor in repeat dislocations after surgery is the patient. It’s important to follow the surgeon’s instructions. A shoulder sling may be needed for up to four weeks. Exercises must be done daily. Doing too much too soon is a common way to undo the benefits of the surgery.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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