Arthroplasty

The Procedure

Please note, the procedure may vary based on the treatment being carried out. Operation and recovery time are affected by the severity of a patient’s condition and his/her overall health.

First, the patient undergoes either general anesthesia (he/she is put to sleep) or localised anesthesia (the operative area is numbed and the patient remains awake). An anesthesiologist remains present to monitor blood pressure, heart rate, breathing and blood oxygen levels.

Second, the orthopaedic surgeon gains access to the inside of the joint. He makes an incision and works his way through the soft tissue to expose the affected area. Next, the bones are reshaped in preparation for the implants.

In an arthroplasty, the minimum amount of damaged bone is removed and the surrounding soft tissue is protected. This ensures a stable recovery for the patient. The operation is complete once the prosthesis is fitted to the bone.

Finally, the incisions are closed with stitches or surgical staples and a sterile bandage is applied.

Patients who have scheduled an operation with the Josephides Healthcare Clinic receive a call a day before their operation. Specific instructions are given on how to prepare for the operation and what to expect on the day of the surgery.

Causes of Arthroplasty

A common instigator of joint replacement surgery is arthritis.

There are several types including:

Osteoarthritis

Is commonly an age-related disease. The cartilage in the shoulder joint softens and wears away, which causes the joint to deteriorate.

This disease affects both men and women and is more commonly found in people aged 50 and above.  Osteoarthritis may also develop in younger people though less frequent.

Patients who have osteoarthritis, often experience debilitating stiffness and/or pain. Arthroplastic surgery allows the surgeon to remove the diseased joint and replace it with prosthetics.

Rheumatoid Arthritis

Is a long-term autoimmune disorder. It causes chronic inflammation of the synovial membrane (joint capsule). The membrane thickens and over time the inflammation may damage the cartilage. People suffering from this form of arthritis feel pain, stiffness and warmth in their joints.

Post-traumatic Arthritis results from a serious shoulder injury. It begins to develop after trauma and progresses to include tenderness, joint instability, pain, swelling and in general the deterioration of the joint.

If left untreated, fractured bones and torn tendons/ligaments can have a series of aftereffects that harm the articular cartilage of the joint. In severe cases, this type of arthritis may cause a patient to lose shoulder function and experience severe pain.

Rotator Cuff Tear /Arthropathy

A rotator cuff is a series of tendons that belong to the 4 muscles of the shoulder. The cuff stabilises the glenohumeral joint, which oversees the abducting and rotating of the humerus bone.

A rotator cuff tear is when one or more of the tendons tear. This type of injury compromises the function of the shoulder and may even develop from irritation and overuse of the muscles or tendons. A massive tear, if left untreated, may require a special type of prosthesis called a reverse-prosthesis.

Avascular Necrosis (Osteonecrosis)

Avascular necrosis occurs when the blood supply to the bone is disrupted. Because bone cells die without a blood supply, osteonecrosis can ultimately cause destruction of the shoulder joint and lead to arthritis. Patients who suffer from Osteonecrosis experience a lot of pain. Chronic steroid use, severe fracture of the shoulder, deep sea diving, heavy alcohol use and sickle cell disease are risk factors for avascular necrosis.

Severe Fractures

A severely fractured shoulder may also be treated with joint replacement surgery. Orthopaedic surgeons recommend arthroplasty if the upper arm bone has shattered and restoring it is impossible. Patients with osteoporosis are more at risk for severe fractures.

Josephides Healthcare Clinic provides arthroplastic treatment for the hips, knees, ankles, feet, shoulders, elbows and fingers.

This procedure may be recommended when non-surgical treatments are exhausted and fail to provide relief.

Non-surgical Treatments Include

• Anti-inflammatory medications
• Pain (Analgesic) medications
• Cortisone injections
• Physical therapy
• Assistive devices for walking (e.g. cane or crutches)
• Viscosupplementation injections (to add lubrication into the joint to make joint movement less painful)
• Weight loss (for overweight and obese patients)
• Food supplements (e.g. Glucosamine or chondroitin sulfate)
• Exercise and conditioning