Standard or reverse shoulder replacement
The shoulder joint is composed of the shoulder blade and the head of the humerus. It is covered with the rotator cuff tendons and the deltoid muscle, which enable movement.
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Osteoarthritis is the wear and tear of the cartilage on the humeral head and the glenoid cavity of the scapula.
A shoulder replacement is indicated in the case of osteoarthritis for which medical treatment is ineffective.
When the rotator cuff tendons in the shoulder are preserved, a so-called “anatomical” total shoulder replacement can be proposed.
An anterior incision is made in the shoulder.
The muscles are moved aside to expose the anterior shoulder tendon. Humeral head can then be exposed and cut.
Different rasps are used to prepare the surface for the insertion of the humeral implant.
The glenoid cavity is then exposed. The bone is specifically prepared using different cutters. The implant is second to place.
The implant is then reduced. Immobilization of the shoulder for 3 weeks followed by prompt rehabilitation will help ensure recovery of a painless, normal range of motion.
With osteoarthritis and a pre-existing tear of the shoulder tendons, the humeral head tends to migrate upwards.
A standard anatomical replacement is not possible.
A reverse replacement is necessary that can offset the lack of tendons.
The same approach is used.
The humeral head is cut. Then, the bone is prepared with rasps to allow the placement of the socket-shaped humeral component.
The humeral glenoid is then exposed. The bone is prepared using different cutters. This preparation enable placement of a cementless component fixed with 4 screws in which the glenoid hemisphere can be inserted.
The 2 implants are put back into place. The deltoid muscle in the shoulder can once again assume its lifting role thanks to the shape of the implant.
The shoulder is no longer painful and full range of motion is generally restored.
Post-operative recovery is the same, with immobilization in a vest for 3 weeks.