In our body, the shoulder joint is a crucial joint with the widest range of motion. Your doctor may suggest replacement surgery if the pain is so severe that it prevents you from reaching into cabinets, impairs your ability to sleep, or causes you to suffer other symptoms. You can have more mobility and pain relief after this procedure.

Anatomy of Shoulder and Its Functions

The shoulder joint, also referred to as the glenohumeral joint, is a ball and socket joint that offers the largest range of motion in the human body. The muscles of the shoulder perform a variety of tasks, such as internal and external rotation, flexion, extension, abduction, and adduction.

The scapula, the primary bony structure of the shoulder, is the site of all muscle interaction. The glenoid cavity, the articular surface of the glenohumeral joint, is located at the lateral aspect of the scapula. The glenoid labrum, shoulder joint capsule, supporting ligaments, and the myotendinous attachments of the rotator cuff muscles encircle and reinforce the glenoid cavity on its periphery. The stabilization of the shoulder joint is largely dependent on the shoulder muscles. The primary muscle group supporting the shoulder joint is the rotator cuff.

An Overview of Shoulder Replacement

Shoulder replacement entails extracting broken bone fragments and putting metal and plastic implants in their place. Shoulder implants come in a variety of shapes and sizes. There are options for both full and partial replacements using anatomic or reverse implants.

When Does Shoulder Replacement Surgery Is Considered?

Shoulder replacement surgery is mainly used to treat patients with joint dysfunction. Usually, all other treatment options like physical therapy and medication are considered first. The procedure will be conducted if you experience any of the following symptoms:

• An excruciating shoulder pain that makes it difficult to perform daily tasks like leaning, putting on clothes, and opening cabinets.
• Decrease in mobility of the shoulder
• Weakness of the shoulder
• Inability to get proper sleep due to shoulder pain
• When none of the other treatment options work such as cortisone injections, physical therapy, and anti-inflammatory drugs
• When the symptoms have not been resolved by previous arthroscopic surgery, rotator cuff repair, or fracture care.

What Conditions Can Lead To Requirements of Shoulder Replacement?

The following are the most typical causes of shoulder replacement surgery:

• Osteoarthritis – A condition that affects the cartilage that coats the ends of bones and facilitates smooth joint movement. Also referred to as wear-and-tear arthritis
• Rotator cuff tear arthropathy – A collection of tendons and muscles called the rotator cuff encircles the shoulder joint. Shoulder joint cartilage and bone can occasionally sustain damage as a result of rotator cuff injuries
• Avascular necrosis / Osteonecrosis – Caused by a temporary or irreversible reduction in the blood supply to the bone. The bone collapses when the blood supply is cut off as the bone tissue dies
• Rheumatoid arthritis and other inflammatory diseases – Brought on by an overactive immune system, can harm the joint’s cartilage and, in rare cases, the underlying bone.
• Fractures – Because of the injury or if the previous attempt at fracture fixation failed, replacement may be necessary for upper humerus fractures.

In India, shoulder replacement surgery is becoming a cost-effective and high-quality medical option for individuals seeking relief from debilitating shoulder conditions. Shoulder replacement surgery cost in India is significantly lower than in many Western countries, making it an attractive destination for medical tourists. The expenses are influenced by various factors, including the choice of hospital, the type of implant used, the surgeon’s expertise, and post-operative care. However, even with these variables, patients often find that the overall cost remains substantially lower than in many developed nations, without compromising the quality of medical care.

Types of Shoulder Replacement Surgery

Surgery is typically considered only if conservative measures such as physical therapy and occasional cortisone injections fail. Different types of shoulder replacement procedures can be employed depending on the patient’s age, overall health, desired level of activity, range of motion, and the size and location of the tear as well as other factors.

• Hemiarthroplasty: This procedure replaces just the stem and ball of the shoulder joint. The stem is connected to the ball and articulates with the natural socket.
• Resurfacing Hemiarthroplasty: In this procedure, only the humeral head is replaced with a prosthesis, and the natural stem of the shoulder joint is preserved.
• Anatomic Total Shoulder Replacement: A highly polished metal ball attached to a stem on the humeral side and a plastic cup on the glenoid socket replaces the arthritic joint.
• Stemless Total Shoulder Arthroplasty: This type of total shoulder arthroplasty preserves bone by attaching the metallic ball only to the upper arm without the need for a stem.
• Reverse Total Shoulder Replacement: This procedure involves reversing the shoulder joint, placing a metal ball in the location of the glenoid socket, and moving a plastic cup that is attached to the stem to the humerus, the upper arm bone.

Pre-surgical Tests and Diagnosis

Your symptoms will be thoroughly reviewed first before considering the surgery. One to two weeks prior to surgery, a series of pre-surgical tests will be arranged. It may include

• Physical exam – It will help the surgeon to identify the cause of pain and the reduction in range of motion
• Blood tests – The level of certain hormones or blood components will be determined to ensure your overall health
• Electrocardiogram – to assess your heart’s electrical activity, and to confirm that you are medically fit for surgery
• X-rays and CT scans – They show if there are any narrowed joint spaces, damaged joint surfaces, and bone spurs. If your shoulder is traumatized or injured, the x-ray will help your doctor determine whether your shoulder can be replaced or if it can be treated in other ways.

Pre-Operative Care

Certain medications might need to be stopped because they make surgery more difficult, but you might still need to take other medications. Unless otherwise directed, you should stop taking any anti-inflammatory drugs, such as aspirin, one week prior to surgery. During this visit, you will receive instructions regarding your daily medications. The day before your procedure, you are not permitted to eat or drink anything after midnight. The best kind of anesthetic will be discussed by the anesthesiologist and your doctor depending on your condition.

Shoulder Replacement Surgery Procedure

The surgery is conducted under general or local anesthesia, to ensure that there is no pain. The surgeon makes an incision, exposing the shoulder joint, and carefully removes the damaged portions. Subsequently, the artificial components are precisely fitted into place, and secured with medical-grade cement or press-fit techniques. The surgeon then closes the incision, and the patient begins the recovery process.

Post-surgical Care

Post-surgery, rehabilitation plays a crucial role, involving physical therapy to restore strength, flexibility, and functionality to the shoulder joint.

Pain management is crucial because shoulder surgery is a painful procedure, you will need to take oral painkillers to stay comfortable. You will be encouraged to move around and get out of bed during your hospital stay. Your physical therapist will guide you in understanding particular exercises and limitations, as well as how to perform them at home. Upon your release, written instructions will also be provided to you. These exercises are generally easy to perform and don’t take much time.

Recovery and Outcomes

The effectiveness of your total shoulder joint replacement greatly depends on how well you complete your exercises. Over a year, your muscles will be gradually and methodically strengthened and stretched through this structured exercise program. The best possible outcome from your new total shoulder replacement is what you want. The majority of patients do not need physical therapy, but in some circumstances, following hospital discharge, formal outpatient physical therapy may be necessary. Depending on how well you are doing with the self-directed exercises, your surgeon will talk to you about this during your follow-up office visits.

Benefits of Having Shoulder Replacement Surgery

You will experience the following benefits if you undergo a successful shoulder replacement surgery:

• Alleviation of pain
• Increase range of motion
• Improvement of shoulder function
• Better quality of life

Risks Associated With Shoulder Replacement

Every surgery has some risk involved. The chances of complications are higher if you have diseases like diabetes. Certain complications that can happen after shoulder replacement surgery:

• Infection
• Wear and tear of the artificial joint
• Nerve and blood vessel damage
• Dislocation of the shoulder joint

Conclusion

Considering shoulder replacement surgery is a significant decision, and caution is essential for several reasons. Choosing a qualified and experienced orthopedic surgeon is paramount. Renowned hospitals and skilled orthopedic surgeons in India offer state-of-the-art facilities, cutting-edge technology, and personalized care, ensuring that patients receive world-class treatment at a fraction of the cost they might incur elsewhere. This combination of the affordability of shoulder replacement surgery cost in India and the quality delivered has positioned India as a sought-after destination for individuals seeking a cost-effective solution to shoulder ailments through replacement surgery.