TOTAL OR PARTIAL SHOULDER ARTHROPLASTY → DUE TO TRAUMATIC (FRACTURE) OR DEGENERATIVE REASON → ANATOMIC OR REVERSE PROSTHESIS
Shoulder joint replacement with a prosthesis has been routinely performed for several years. Its purpose is to relieve pain caused by degenerative (osteoarthritis, inflammatory arthritis) or traumatic (fractures) conditions of the glenohumeral joint, as well as, where possible, to allow functional recovery of the arm.
Particularities of the glenohumeral joint
The glenohumeral joint is the main part of the shoulder joint complex, which consists of three joints (glenohumeral, acromioclavicular, and sternoclavicular), as well as two gliding planes (omothoracic and acromiohumeral). The biomechanical characteristics of the glenohumeral joint are:
- Una pequeña congruencia ósea (la superfície articular de la glena es plana y de pequeño tamaño, frente a una cabeza humeral esférica y ampliamente recubierta de cartílago).
- The muscles and tendons of the rotator cuff act on both motor skills and stability of the shoulder.
Due to its great mobility, the glenohumeral joint is subject to significant forces and contacts ("conflicts") between bone surfaces and/or soft tissues at the end of movements, which explains the relative frequency of shoulder injuries.
Indications for shoulder prosthesis
Shoulder prostheses are designed to replace the bone structures of the glenohumeral joint affected by degenerative or traumatic pathologies.
As with most orthopedic conditions, the general indication for shoulder replacement depends primarily on the intensity of the pain and its resistance to various so-called conservative treatments (anti-inflammatory and analgesic medications, physical therapy, balneotherapy, etc.). The degree of joint limitation is of secondary importance when considering surgery.
However, clinical successes due to improved implant quality and surgical techniques, along with increased life expectancy and the desire to prolong personal independence, have made shoulder replacement increasingly common.
Different types of prostheses have been developed, the relative indication of which depends on both local conditions and the underlying pathology.
Partial shoulder prosthesis
Partial shoulder replacement is indicated if the condition is limited to the humeral side (fractures of the humeral head with three or more fragments, avascular necrosis of the humeral head) and when bone wear in the glenoid cavity no longer allows the prosthesis to be fixed (advanced rheumatoid arthritis).
Total anatomical prosthesis
Anatomical total shoulder prosthesis is currently proposed in cases of degenerative disease of the glenohumeral joint, affecting both articular surfaces, with a glenoid bone stock that allows the implantation of a prosthesis and with a competent rotator cuff.
Total inverted prosthesis
A significant number of patients suffer from degenerative glenohumeral pathologies that involve damage to bone structures associated with rotator cuff incompetence.
In these cases, a total anatomical prosthesis is contraindicated and a hemiprosthesis does not allow for satisfactory functional recovery.
The reverse total prosthesis is an alternative. However, the bone stock in the glenoid cavity must be sufficient to accommodate the glenoid prosthesis. In contrast, the rotator cuff's integrity is not required.
This information is provided by specialized healthcare personnel for informational purposes only and does not replace medical advice.
If you would like to make an appointment with our shoulder specialist, you can contact us by phone at 946 941 347 or by using the following form.
