Reversing the Pain with Innovative New Shoulder Replacement

Think about all the lifting, reaching, pulling and pushing you do every day – whether it’s bringing in a bag of groceries, combing your hair, sweeping the floor, hammering a nail or throwing a ball. With all we demand of our shoulders, it’s really not that surprising that shoulder pain is a very common problem.

Geoffrey Collins, MD, orthopaedic surgeon and shoulder specialist with Center for Orthopaedics, explains that what most people call the shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion to the arm. Mobility can take a toll, however. “Over time, repetitive motion activities on the job or through sports activities may lead to shoulder pain.”

For Mable Moore, age 66, of Moss Bluff, it was her years of work in a school cafeteria and as a janitor that caught up with her after she retired. She had severe arthritis in both of her shoulders. “The pain was so bad I could barely lift my arms. I couldn’t do anything around my house; I couldn’t even wash my hair. That’s when I knew I had to do something.”

And do something she did. Moore has had not just one, but both, of her shoulders replaced over the past two years. Dr. Collins used a relatively new procedure called the “reverse shoulder replacement” at West Calcasieu Cameron Hospital. He explains that this technique is designed to eliminate pain and restore function in people with severe shoulder arthritis who also have a tear in the rotator cuff. “The rotator cuff is essentially a cushion that prevents cartilage from rubbing on bone while at the same time providing an attachment for four muscles that are necessary for raising the arm. Basically, the rotator cuff kept things moving easily and intact. When that becomes damaged, it causes pain and loss of mobility.”

Dr. Collins says people with severe shoulder arthritis combined with damage to the rotator cuff are generally not good candidates for standard total shoulder replacement because traditional shoulder replacement will not restore function and will relieve only part of the pain.

The conventional replacement joint uses a metal ball on the top of the arm bone, and a plastic socket on the shoulder blade; thus the ball-and-socket joints are replaced. The reverse shoulder replacement uses a ball-and-socket joint as well, but the ball is placed on the shoulder blade and the socket is placed on top of the arm bone; opposite of the normal anatomy which explains why it is known as “reverse” shoulder replacement. “By reversing the socket and metal ball, the center of rotation is maintained. This shifts the strength needed to move the arm away from the damaged rotator cuff muscles and is instead shifted to the healthier deltoid muscle, solving the problem of what to do with the problematic rotator cuff,” explains Dr. Collins. “Before reverse shoulder replacement, we could relieve pain but normal motion was not restored to satisfactory levels. With a reverse procedure, we’re able to relieve pain and restore motion. Patients report a big improvement and are able to return to normal activities and enjoy life again.”

Mrs. Moore is one of those very happy patients. “Before my first surgery, I was ready to cut my arm off it hurt so bad,” she said. “I had tried other treatments and nothing helped. I was not eager to have surgery. I knew other people who had had a shoulder replacement and weren’t happy, but I was to the point that nothing could be worse than what I was already experiencing. I was so glad I did it. The entire experience was much better than I expected and I recovered quickly. I was more than eager to have the second arm done, and I just had my one-year follow-up appointment. I have full use of my shoulders again and am back to doing everything I want to do. I’m so glad Dr. Collins offered this type of procedure and that I could have it done right here at West Calcasieu Cameron Hospital.”

This reverse shoulder procedure has been used for nearly 15 years in Europe, and was approved by the United States’ Federal Drug Administration several years ago. Studies show very positive results from the data collected to this point. Dr. Collins has 13 years of experience in shoulder surgery, and is specifically trained in reverse shoulder replacement. He says patients who are candidates for this procedure are usually over age 60 and have both a damaged rotator cuff and arthritis in the shoulder. They usually report severe, constant pain and limited motion in their shoulder.

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