Revision Shoulder Arthroplasty
Revision Shoulder Arthroplasty (Shoulder Replacement)
Total shoulder arthroplasty is a highly effective treatment for many shoulder conditions, most commonly severe osteoarthritis. Shoulder replacement provides reliable pain relief and improved range of motion. Yet sometimes a total shoulder replacement produces unsatisfactory results and requires revision surgery.
Hemiarthroplasty is a partial shoulder replacement where the damaged head of the upper arm bone is replaced with a prosthetic head. This procedure is performed to treat pain associated with osteoarthritis that only affects the head of the upper arm bone.
The most common type of revision surgery for an unsatisfactory primary total shoulder replacement and a failed hemiarthroplasty is a reverse shoulder arthroplasty. It has low complication rates and provides good improvement in pain and function.
Revision surgery is defined as a procedure in which prosthetic components are completely or partially exchanged or removed.
The most common reasons are rotator cuff insufficiency, dislocation, infection, and glenoid component (implant) loosening. Other indications for revision surgery include persistent pain and stiffness, weakness, other component failure, bone loss, fracture around the implants, and nerve injury.
Unsatisfactory results can result from progressive arthritis stiffness, weakness, instability, pain, failure to heal, infection and nerve injury.
The surgery is technically complex and requires expertise. When results are unsatisfactory, it is important to identify and address the causes. A thorough evaluation of the patient and their is essential to determining the cause and the best treatment. First, Dr. Petrigliano will discuss with you the symptoms you are experiencing. He review your medical history and order previous medical records including x-rays, imaging studies, the reasons for the first shoulder replacement and surgical records including the type and size of the implants, details of your previous surgical replacement, and postoperative rehabilitation.
He will perform a comprehensive physical exam of the shoulder testing range of motion, stability, strength and shoulder movement. He will order x-rays and new CT and MRI scans, and evaluate nerve function, rotator cuff function, and bone health. He may evaluate shoulder instability using ultrasound. He will also order new lab studies. This will help Dr. Petrigliano to determine the nature of your problems and evaluate potential causes.
Once he has determined the reason for the unsatisfactory results, and the causes of the unsatisfactory results, and the results of his thorough workup, he will develop a preoperative surgical plan for removal of the old implants and the type of replacement that is best for your specific needs.
Depends on the cause of the need for replacement and the current status of the bone and soft tissues. The most common reason for a total shoulder arthroplasty is shoulder osteoarthritis. The patient must have intact rotator cuff tendons. The most common type of revision shoulder replacement is called a reverse shoulder replacement.
This revision surgery is best for patients who have severe shoulder arthritis, torn rotator cuff tendons, severe shoulder weakness and a previous failed total shoulder replacement.
A reverse technique offers stability and does not rely on the rotator cuff tendons. The deltoid muscle is used to move the shoulder instead of the rotator cuff. Thus, this approach is perfect when the damaged shoulder needs new surfaces, but there is not enough healthy tissue to stabilize and move the shoulder. A reverse shoulder is technically more technically complex and challenging than a total shoulder replacement.
When you or a loved one suffers with an unsatisfactory shoulder replacement, contact Dr. Frank Petrigliano, a highly respected shoulder expert and sports medicine specialist. He is an internationally renowned orthopedic surgeon and the Chief of the Epstein Family Center for Sports Medicine at Keck Medicine of USC in Los Angeles, CA. He is specialty is shoulder surgery. His goal is to return his patients to the life they love and the sports that make life worth living with minimal interruption. Contact him at one of this three convenient locations to schedule a consultation and receive the correct diagnosis, all your treatment options, and expert personalized care.
At a Glance
Dr. Frank Petrigliano
- Associate Professor of Orthopaedic Surgery at USC
- Chief of the Epstein Family Center for Sports Medicine
- Team physician for the LA Kings and USC Athletics
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