关节置换

What is a Reverse Total Shoulder Replacement?

作者：John G. 马里兰州Costouros

The shoulder is the most complex joint in the human body. 动态的相互作用 of bones, muscles and tendons, while allowing for greatest range of motion of any joint in the human body, also makes it uniquely susceptible to 受伤. Over time, the pain and diminished motion that these types of injuries cause can seriously affect one’s quality of life.

While many shoulder issues can be treated with nonsurgical methods like medications, physical therapy or injections, shoulder surgeries are increasingly common and able to provide predictable outcomes and durable results. In fact, there are many procedures available that use arthroscopic techniques in which a small incision is made and a tiny high-definition camera is used with specialized instruments to guide the surgeon through minimally-invasive 手术. Because they’re less invasive, there’s typically less postoperative pain and bleeding, more cosmetic incisions which are barely visible, shorter surgical times, lower risk of infection, and faster 复苏. These are also outpatient procedures, allowing patients to go 手术当天就回家了.

However, when a shoulder joint has degenerated to the point it needs to be replaced, patients can opt for a 全肩关节置换术 or reverse 全肩关节置换术.

有什么区别？?

While both the 全肩关节置换术 and reverse 全肩关节置换术 involve replacing the surfaces of the shoulder joint with prosthetic components made of metal and plastic, the difference is how these prostheses are 配置.

Your shoulder joint consists of a ball and socket. 球(或肱骨 head) is part of your arm bone (humerus), and rests in the socket portion 肩胛骨（肩关节）. 用一个反向假体，球 is placed on the shoulder blade side of your joint, while the socket is on the arm side – a reversal of your normal anatomy. 这改变 the mechanics of the shoulder and allows the deltoid muscle to power the 手臂的开销. Reverse shoulder replacement concept has been used successfully around the world for over 30 years and was FDA-approved for use in the 2004年的美国.

Why Get a Reverse Total Shoulder Replacement?

Sometimes, the muscles and tendons of the rotator cuff within the shoulder are so damaged that a standard 全肩关节置换术 won’t 表现良好. This can lead to poor motion and loosening of the components. When these tendons are torn to the point they no longer attach to bone, a person will be unable to lift their 手臂的开销, out to the side, or 把手伸到他们背后. 这对生活质量有不利影响.

Because it doesn’t rely on the tendons and muscles of the rotator cuff, a reverse prosthesis offers the best chance of restoring use of 手臂和活动范围.

什么是手术经验?

Surgery and 复苏 time depend largely on whether it’s the first shoulder replacement (primary) or if there is an existing prosthesis that needs to be removed and replaced (revision).

For all shoulder procedures, a nerve block is done followed by a general 麻醉. An incision is made in the front of the shoulder through which 切除恶化的肩关节. 通常，这种类型的程序 takes less than an hour in the hands of an experienced shoulder specialist.

While a patient may begin some elbow, wrist, and hand motion immediately following 手术, movement of the shoulder may be limited for a few days 到几个星期. Physical therapy is a crucial part of obtaining the best possible outcome following shoulder replacement 手术. 缓解疼痛 is rapid following shoulder replacement and return of range of motion is more gradual as patients progress through their formal physical therapy 和练习.

Reverse Total Shoulder Replacement at the IJRR

As one of the first surgeons to bring reverse shoulder replacement to the U.S., I’ve seen how this procedure can change lives and treat a 广泛的复杂肩部问题. 现在，16年过去了，我 had the privilege of participating in several clinical trials to refine this and other shoulder procedures, as well as helped with the development of better prostheses and implants that are currently in use.

我决定加入新葡京医院 Institute for Joint Restoration and Research in order to bring shoulder joint replacement 手术 to a place that has set the bar so high for patient outcomes and quality of care. 我想要的 我的技能和专业知识是其中的一部分. 以成功为基础 of the hip and knee replacement specialties pioneered at the IJRR, we’re now able to add 全肩关节置换术 and reverse total shoulder replacement to our advanced surgical offerings.

Learn more about how education and specialization are improving quality 为我们的病人的生命，与 这个视频 on the Institute for Joint Restoration and Research.

2020年3月发布