Total Shoulder Arthroplasty: Difference between revisions
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The first record of shoulder arthroplasty was performed in 1894 by the French surgeon, Jean Pean (Gregory). The original implant consisted of a platinum and rubber implant for the glenohumeral joint. Charles Neer is credited with the advancement of modern TSA, developing more modern prostheses for surgical procedures beginning in the 1950’s(Gregory, Keller,Wilcox) . <br>There are approximately 23,000 shoulder replacement surgeries performed each year compared to 400,000 knee replacements, and 343,000 hip replacements (AAOS website). This is largely due to the relative complexity of the anatomy and biomechanics of the shoulder joint. Because of the complexity of the region, there are multiple variations in prostheses and surgical procedures that are performed depending on the tissues that are implicated. Since Neer’s initial design in 1951, more than 70 different shoulder systems have been designed for shoulder reconstruction arthroplasty(waiter 2009). The earliest shoulder replacement procedures were limited to treating proximal humeral fractures, but current implications for shoulder arthroplasty include: primary osteoarthritis, posttraumatic arthritis, inflammatory arthritis, osteonecrosis of the humeral head and neck, pseudoparesis caused by rotator cuff deficiency, and previous failed shoulder arthroplasty. Understanding the different prosthetic options and indications for each impairment is important for all practitioners in the health care continuum. Algorithms have been developed to assure each patient is matched with the correct procedure and fitted with the right prosthetic option. Below are examples from Wiater and Fabing detailing the method for selecting the proper procedure(Wiater).<br><br><br><br> | The first record of shoulder arthroplasty was performed in 1894 by the French surgeon, Jean Pean (Gregory). The original implant consisted of a platinum and rubber implant for the glenohumeral joint. Charles Neer is credited with the advancement of modern TSA, developing more modern prostheses for surgical procedures beginning in the 1950’s(Gregory, Keller,Wilcox) . <br>There are approximately 23,000 shoulder replacement surgeries performed each year compared to 400,000 knee replacements, and 343,000 hip replacements (AAOS website). This is largely due to the relative complexity of the anatomy and biomechanics of the shoulder joint. Because of the complexity of the region, there are multiple variations in prostheses and surgical procedures that are performed depending on the tissues that are implicated. Since Neer’s initial design in 1951, more than 70 different shoulder systems have been designed for shoulder reconstruction arthroplasty(waiter 2009). The earliest shoulder replacement procedures were limited to treating proximal humeral fractures, but current implications for shoulder arthroplasty include: primary osteoarthritis, posttraumatic arthritis, inflammatory arthritis, osteonecrosis of the humeral head and neck, pseudoparesis caused by rotator cuff deficiency, and previous failed shoulder arthroplasty. Understanding the different prosthetic options and indications for each impairment is important for all practitioners in the health care continuum. Algorithms have been developed to assure each patient is matched with the correct procedure and fitted with the right prosthetic option. Below are examples from Wiater and Fabing detailing the method for selecting the proper procedure(Wiater).<br><br><br><br> | ||
== | == Medical Management (current best evidence) == | ||
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== Complications == | == Complications == | ||
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== Post Surgical Presentation/Precautions == | == Post Surgical Presentation/Precautions == | ||
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== | == Physical Therapy Management (current best evidence) == | ||
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== | == Expected Outcomes == | ||
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Revision as of 04:16, 28 November 2010
Original Editors
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Search Strategy[edit | edit source]
Search Databases: Cochrane Library, CINAHL PLUS with full text, Medline with full text, Proquest, Google Scholar. Search dates: 10/25/10-11/13/10.
Search terms: Total Shoulder Arthroplasty, Shoulder Arthroplasty, Shoulder Surgery AND Rehab, Reverse Shoulder Arthroplasty, Shoulder Replacement, Shoulder surgery AND complications
Definition/Description[edit | edit source]
Total shoulder arthroplasty, or TSA, is a procedure used to replace the diseased or damaged ball and socket joint of the shoulder with a prosthesis made of polyethylene and metal components. The “ball” is the proximal head of the humerus and the “socket” refers to the concave depression of the scapula referred to as the glenoid.(multi-source)
A reverse total shoulder arthroplasty, or rTSA, refers to a similar procedure in which the prosthetic ball and socket that make up the joint are reversed to treat certain complex shoulder problems. (multi-source)
Epidemiology /Etiology[edit | edit source]
The first record of shoulder arthroplasty was performed in 1894 by the French surgeon, Jean Pean (Gregory). The original implant consisted of a platinum and rubber implant for the glenohumeral joint. Charles Neer is credited with the advancement of modern TSA, developing more modern prostheses for surgical procedures beginning in the 1950’s(Gregory, Keller,Wilcox) .
There are approximately 23,000 shoulder replacement surgeries performed each year compared to 400,000 knee replacements, and 343,000 hip replacements (AAOS website). This is largely due to the relative complexity of the anatomy and biomechanics of the shoulder joint. Because of the complexity of the region, there are multiple variations in prostheses and surgical procedures that are performed depending on the tissues that are implicated. Since Neer’s initial design in 1951, more than 70 different shoulder systems have been designed for shoulder reconstruction arthroplasty(waiter 2009). The earliest shoulder replacement procedures were limited to treating proximal humeral fractures, but current implications for shoulder arthroplasty include: primary osteoarthritis, posttraumatic arthritis, inflammatory arthritis, osteonecrosis of the humeral head and neck, pseudoparesis caused by rotator cuff deficiency, and previous failed shoulder arthroplasty. Understanding the different prosthetic options and indications for each impairment is important for all practitioners in the health care continuum. Algorithms have been developed to assure each patient is matched with the correct procedure and fitted with the right prosthetic option. Below are examples from Wiater and Fabing detailing the method for selecting the proper procedure(Wiater).
Medical Management (current best evidence)[edit | edit source]
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Complications[edit | edit source]
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Post Surgical Presentation/Precautions[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Expected Outcomes[edit | edit source]
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Key Research[edit | edit source]
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Resources
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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