Videos

Part 1
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.

Part 2
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.

The shoulder tendons, which compose the rotator cuffs, are inserted in the upper extremity of the humerus. The acromion is part of the scapula and forms the top of the shoulder. The tendons rub against the acromion if it is too curved, resulting in irritation and rupture. The acromion is firstly trimmed in order to remove the impingement or excessive contact with the tendons. The bone of the humeral head is prepared to receive the anchors, which will enable the repair. The threads attached to these anchors are passed through the tendon and are tied together to reattach the tendon to the bone. The tendon is thus repaired and there is no longer any excess contact between the tendon and the acromion. As a result, the tendon can heal by averting repeated rupture. The shoulder thus recovers mobility and strength, and is no longer painful.
This operation is performed arthroscopically, without opening the shoulder, through small incisions using a camera to visualize the joint. The operation preserves the other shoulder muscles and enables rapid recovery.

The shoulder tendons are covered by what is called the acromion, which is part of the scapula. This acromion can be too curved or hooked causing premature contact with the tendons and thus rubbing during repeated movement of the shoulder. This irritates the tendons, which become inflamed and can rupture. The operation consists in resecting the inferior side of the acromion to flatten it and thus prevent the tendons from rubbing during movement. This is done using a small, motorised cutter, thus relieving the pain and preventing the premature wear of the tendons.
This operation is performed arthroscopically, without opening the shoulder, through small incisions using a camera to visualize the joint. The operation preserves the other shoulder muscles and enables rapid recovery.

– In the case of an unstable shoulder where the bone lesions and stress on the joint are relatively minor, the first technique consists in tightening the ligaments arthroscopically, that is through small incisions using a camera to view the joint.
The anterior zone of ligament detachment is abraded to optimize healing.
Anchors are implanted in the glenoid bone near the surface of the cartilage with threads that are then passed through the ligaments to reinsert and tighten them.
The shoulder is thus stabilized, which helps prevent recurrent luxations whilst conserving the natural environment of the shoulder.

– Sometimes, damage that is more significant can result in an unstable shoulder. Particularly in the case of bone damage, whether it entails the humeral head or the glenoid cavity, the Latarjet bone graft technique is preferred. This operation consists in removing the end of the coracoid where the biceps muscle is attached.
The bone fragment is then placed in the damaged part of the glenoid cavity and secured with screws. Displacing this bone fragment has no effect on function.
The lost bone is replaced and the modified insertion of the biceps dynamically stabilizes the humeral head with the biceps muscles thus preventing luxation.
Choosing this technique to stabilize the shoulder enables rapid resumption of very demanding activities and considerably limits the risk of relapse.
It can be performed using a non-invasive minimal anterior approach.