About Revision Shoulder Replacement

Anyone who has ever watched either of the Williams sisters wield a tennis ball across the court at a U.S. Open Championship can agree that their mastery of the sport makes every stroke and serve seem effortless. While talent, skill, endless hours of practice, and determination have made Venus and Serena household names in both professional tennis and popular culture, none of it would be possible without the work of the shoulder, one of the body’s largest and most complex joints that Los Angeles orthopedic oncologist, Dr. Daniel C. Allison, has studied extensively.

Anatomy of the Shoulder Joint

Like the hip, the shoulder is a ball and socket joint, which allows for multi-directional range of motion and movement of the arms. The shoulder blade, or scapula, acts as the socket, and the humerus, or upper bone of the arm, fits into the socket with enough room to allow for rotation and flexible motion of the arm and shoulder. The scapula also consists of two bony projection structures called the acromium and coracoid process. The collar bone (clavicle) connects to the acromium in a structure known as the acromioclavicular joint.

Like the knee and hip joints, the shoulder also consists of a network of muscles, tendons, and cartilage that help to provide balance and stability in the joint. The most prominent layer of muscles and tendons in the shoulder is the rotator cuff, which enables the range of motion and control in the shoulder necessary to send a Venus or Serena level backhand serve down the tennis court at Wembley or New York.

The rotator cuff is supported by small fluid filled sacs called bursae, and the head of the humerus is cradled by a cylindrical layer of cartilage called the labrum.

Shoulder Replacement Surgery

Injuries like rotator cuff tears or orthopedic conditions like osteoarthritis in the shoulder, where the cartilage in the joint slowly deteriorates over time are treated with different methods, depending on the extent of the damage to the joint, and on the individual patient. In some cases, injuries respond to conservative treatment like rest, medication, and physical therapy.

In other cases, Beverly Hills based orthopedic surgeon Dr. Daniel C. Allison will use minimally invasive arthroscopic shoulder surgery to repair a torn tendon or to remove bone or cartilage fragments that are causing pain, inflammation, and mobility problems in the shoulder.

When the damage to the shoulder joint is too extensive to treat with conservative methods or localized surgery, Dr. Allison may determine that a total shoulder replacement, also known as shoulder arthroplasty, is necessary.

Shoulder arthroplasty uses a sophisticated metal and plastic prosthetic joint to replace the original.

For more information, visit ncbi.nlm.nih.gov

What is Shoulder Replacement Revision Surgery?

While shoulder replacement has a generally high success rate for most patients, complications and wear and tear to the prosthetic joint sometimes make it necessary for a second, or revision surgery to repair the damage, or replace the joint with a new unit.

The most common symptoms of complications with a primary shoulder replacement

• • Stiffness
  • Weakness
  • Instability
  • Pain
  • Slow/limited healing
  • Infections
  • Nerve problems
  • Limited range of motion

Following a comprehensive physical exam and diagnostic testing, Dr. Allison can determine the extent of damage and the source of the complications with the shoulder replacement, and the best course of treatment to correct the problem. The most common complications with shoulder arthroplasty revision surgery are generally dislocation, or when the prosthesis has shifted or become loose. Dr. Allison determines whether revision surgery is necessary to repair the shoulder joint replacement on a case by case basis.