Shoulder resurfacing for arthritis

Shoulder resurfacing is a superior alternative to shoulder replacement for

arthritis. The knee joint is routinely resurfaced during a knee replacement.
Resurfacing of the hip joint is gaining ground for a variety of arthritic
conditions particularly in young patients. This is the first time that shoulder
resurfacing with the Copeland prosthesis is being introduced in Tamil nadu
Shoulder arthritis is less common than hip & knee arthritis. It mainly affects
older individuals
.

. Causes of shoulder arthritis are

• osteo-arthritis,
• rheumatoid arthritis
• avascular necrosis
• rotator cuff tear arthropathy
• post traumatic arthritis
• post septic arthritis
• post tubercular arthritis.

In shoulder arthritis like any other arthritis, only the top surface of the upper
end of the arm bone (humerus) is affected. The socket is usually not
damaged. There is no bone loss. The traditional operation for a shoulder
arthritic problem is a shoulder replacement. However this involves sacrifice
of bone. In case of severely comminuted fractures and tumours there is no
recourse but to do a shoulder replacement. In India shoulder replacement is a
rare operation and most often the whole diseased portion of bone is removed
and replaced with a total shoulder replacement

.Shoulder replacement technique

In a conventional shoulder replacement, the damaged parts of the joint
comprising the shoulder joint are completely removed and replaced with a
metal and plastic prosthesis. The metal portion is buried into the shaft of the
arm bone (humerus). It has a stem and ball shaped end. The socket is made
of polyethylene with a metal back and stem buried into the outer end of the
shoulder blade.
. Shoulder replacement prosthesis

What is shoulder resurfacing?

The operation consists of shaping the top end of the arm bone to a
hemispherical shape by cheese grating reamers. A central hole is drilled in
the same. The prosthesis is made of Cobalt chrome, molybdenum and coated
on the inside with hydroxyapatite is impacted in. Hydroxyapatite allows
natural bony in growth over time and fixation.
The operation is done through a minimally invasive approach under either
general or regional anesthesia.
The implant helps in preservation of natural bone and tissues of the patient.
It is seen as an ideal option for the younger, active patient who wants to lead
a normal life. This cement less implant utilizes a patient’s natural t issue
growth. It can also be used in the older arthritic patient with good bone
stock.

Shoulder resurfacing prosthesis

Advantages of shoulder resurfacing:

Faster recovery
Preservation of bone stock
Better range of movement

Patient particulars

Mrs. Saleha Khatum from South Africa had been suffering from arthritic
shoulder pain for the past 4- 5 years. Her shoulder had become damaged by
repeated injections of hydrocortisone in to the shoulder.
She was told that she needed shoulder replacement back home but found the
cost phenomenal. She had heard good things about surgery in India and
located Dr.Venkatachalam in Chennai.
After the correspondence she decided to come to Chennai for her surgery
along with her husband.
A resurfacing prosthesis or implant was chosen as it preserves bone. In
future if another revision operation is required, it would be a simple matter
to just remove the metal cap and either fuse the joint or convert it to a total
shoulder replacement.
The Copeland shoulder prosthesis from Biomet was used. This is the only
surface replacement with the longest follow up. This is the first time that this
shoulder resurfacing prosthesis was used in Tamil nadu and Chennai.

Dr.A.K.Venkatachalam
MS Orth,, DNB Orth, FRCS, MCh Orth( Liverpool)
Consultant orthopaedic surgeon
Knee, Hip & Shoulder surgery centre,
Chennai, India
www.shoulderindia.com

Mobile- 9282165002.
E mail akvenkat15@hotmail.com
akvenkat@gmail.com