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Shoulder Replacement Surgery

Shoulder replacement surgery, also known as shoulder arthroplasty, is a procedure to replace the damaged parts of the shoulder joint with artificial components called prostheses. This surgery is typically performed to relieve pain and improve function in patients with severe shoulder arthritis or other conditions that damage the joint.

The shoulder is a ball-and-socket joint that connects the upper arm bone (humerus) to the shoulder blade (scapula). The joint is lined with cartilage, which helps to cushion the bones and allow them to move smoothly. When the cartilage is damaged, it can cause pain, stiffness, and limited movement.

Shoulder replacement surgery is an option for people who have severe shoulder pain and disability that is not relieved by other treatments, such as medication, physical therapy, or injections.

Shoulder Replacement Surgery Types

There are several types of shoulder replacement surgery, each designed to address different needs and conditions. Here are the most common types:

1. Total Shoulder Replacement (TSR)

This is the most common type of shoulder replacement surgery. It replaces the ball and socket of the shoulder joint with artificial components. 

TSR is typically recommended for people with:

  • Severe arthritis: Osteoarthritis and rheumatoid arthritis can damage the cartilage in the shoulder joint, causing pain, stiffness, and limited movement.

  • Rotator cuff tears: Tears in the rotator cuff, a group of muscles and tendons that stabilize the shoulder joint, can also benefit from TSR.

  • Bone fractures: Severe fractures of the humerus head (the ball of the upper arm bone) may also require TSR.

2. Reverse Total Shoulder Replacement (RTSR)

This surgery is specifically designed for people who have lost a significant amount of rotator cuff function. In RTSR, the ball and socket are replaced in reverse order, with the ball component placed in the glenoid (socket) and the socket component attached to the humerus (upper arm bone). This allows the deltoid muscle, which is still functional in most cases, to take over the function of the rotator cuff and lift the arm.

RTSR is often recommended for people with:

  • Massive rotator cuff tears: Tears that are too large to be repaired

  • Rotator cuff tear arthropathy: This condition occurs when a rotator cuff tear has caused significant damage to the shoulder joint

3. Hemiarthroplasty (Shoulder Resurfacing)

This surgery replaces only the ball of the humerus with a metal prosthesis. The glenoid (socket) is left intact. 

Hemiarthroplasty is typically recommended for younger patients with:

  • Osteoarthritis: This surgery is less invasive than TSR and can be a good option for patients who are active and have a good prognosis for recovery.

  • Avascular necrosis (AVN): This condition occurs when the bone in the humerus head dies due to a lack of blood flow.

4. Anatomic Total Shoulder Arthroplasty (TSA)

This surgery is a newer type of TSR that uses more anatomically shaped ball and socket components. This can provide a more natural feel and range of motion compared to traditional TSR. 

Anatomic TSA is often recommended for younger patients with:

  • Early-stage arthritis: This surgery may help preserve bone and delay the need for revision surgery in the future.

  • High activity levels: Anatomic TSA can provide a more natural feel and range of motion, which may be beneficial for active patients.

5. Shoulder Stemless Arthroplasty

This is a newer type of TSR that uses a ball-and-socket component that does not have a stem. This can be beneficial for patients with:

  • Osteoporosis: The stemless design can help reduce the risk of bone fractures.

  • Smaller anatomy: The stemless design can be a good option for patients with smaller bone structures.

  • Younger patients: The stemless design may help preserve bone and delay the need for revision surgery in the future.

The best type of shoulder replacement surgery for you will depend on your individual circumstances and needs. Your doctor will discuss your options with you and help you choose the surgery that is right for you.

Shoulder Replacement Surgery Procedure

The specific steps involved in the surgery may vary slightly depending on the type of surgery being performed and the individual patient's needs. However, here is a general overview of the most common steps involved:

Pre-operative preparation:

  1. Consultation and diagnosis: Your doctor will discuss your symptoms and medical history with you and perform a physical examination. They may also order imaging tests, such as X-rays or an MRI, to get a better picture of the damage to your shoulder joint.

  2. Anesthesia: You will be given general anesthesia before the surgery begins. This will put you to sleep and pain-free during the procedure.

  3. Positioning: You will be positioned on your back on the operating table. Your arm will be raised and supported in a special position.

Surgery:

  1. Incision: The surgeon will make an incision in the front of your shoulder. The size and location of the incision will vary depending on the type of surgery being performed.

  2. Exposure of the joint: The surgeon will carefully move the muscles and tendons to expose the shoulder joint.

  3. Removal of damaged bone and cartilage: The surgeon will remove the damaged cartilage and bone from the ball and socket of the shoulder joint.

  4. Preparation of the bone: The surgeon will prepare the remaining bone for the artificial components. This may involve drilling holes or shaping the bone to accommodate the prostheses.

  5. Implantation of the prostheses: The surgeon will insert the artificial components of the prosthesis into the prepared bone. The ball component is typically made of metal, and the socket component is typically made of plastic or metal.

  6. Closure of the incision: The surgeon will close the incision with sutures or staples.

Post-operative care:

  1. Recovery room: You will be taken to the recovery room where you will be monitored closely.

  2. Pain management: You will be given pain medication to help manage the pain after surgery.

  3. Physical therapy: You will begin physical therapy soon after surgery to help you regain strength and movement in your shoulder.

  4. Discharge: Most people are able to go home the same day as their surgery. However, you will need to have someone drive you home and help you with activities of daily living for the first few weeks.

Shoulder Replacement Surgery Risks and Benefits

Risks of Shoulder Replacement Surgery

 Potential complications of shoulder replacement surgery include:

  • Dislocation

  • Fracture

  • Loosening of the prosthesis

  • Implant loosening

  • Rotator cuff failure

  • Nerve damage

  • Blood clots

  • Dislocation

  • Infection

Benefits of Shoulder Replacement Surgery

  • Pain Relief

  • Improved Range of Motion

  • Increased Strength and Stability

  • Improved Quality of Life

  • Improved Mental Health

Shoulder Replacement Surgery Recovery Time

The recovery time after shoulder replacement surgery varies depending on the individual and the type of surgery performed. However, most people can expect a general timeline for their recovery:

Immediately After Surgery:

  • You will stay in the hospital for 1-2 days after surgery for monitoring and pain management.

  • You will be given a sling to wear for 4-6 weeks to protect the shoulder joint.

  • You will begin gentle range-of-motion exercises within a few days of surgery.

Weeks 1-4:

  • You will continue with range-of-motion exercises and begin strengthening exercises.

  • You will be able to gradually increase your activity level, but you should avoid lifting heavy objects or strenuous activities.

  • You may still experience some pain and stiffness, but it should gradually improve over time.

Weeks 4-6:

  • You will continue with your exercise program and be able to increase your activity level further.

  • You may be able to return to work or school, depending on your job and the type of surgery you had.

  • You should still be careful not to overdo it, but you will be able to participate in most activities.

Weeks 8-12:

  • You should be able to regain most of your strength and range of motion.

  • You can return to most activities, including sports and exercise.

  • You may still experience some occasional pain or stiffness, but it should be mild and improving.

1 Year and Beyond:

  • You should be able to fully participate in all activities without any restrictions.

  • You may still have some minor aches or pains, but they should not be significant.

  • You will need to continue with regular exercise to maintain your strength and range of motion.

Factors that can affect recovery time:

  • Type of surgery

  • Age and overall health

  • Motivation and adherence to rehabilitation

  • Complications

Here are some tips for optimizing your recovery:

  • Follow your doctor's instructions carefully.

  • Attend all of your physical therapy appointments.

  • Do not try to do too much too soon.

  • Ice your shoulder regularly to reduce pain and swelling.

  • Get plenty of rest.

  • Eat a healthy diet.

  • Stay positive and motivated.

Shoulder Replacement Surgery Cost in Delhi

The cost of shoulder replacement surgery in Delhi, India, can vary based on several factors, including the hospital, surgeon's experience, type of shoulder replacement, pre-existing medical conditions, post-operative care, and other associated expenses.

The following table provides an estimated range of costs for shoulder replacement surgery in Delhi:

Shoulder Replacement Surgery Cost Breakup

Shoulder Replacement Surgery Cost Breakup

Cost Component Cost Range
Surgery type
  • Total shoulder replacement: ₹400,000
  • Reverse shoulder replacement: ₹450,000
  • Hemiarthroplasty: ₹350,000
Hospital/Clinic
  • Government hospital: ₹200,000
  • Private hospital (Tier 1): ₹450,000
  • Private hospital (Tier 2): ₹350,000
Surgeon's fees
  • Experienced surgeon: ₹200,000
  • Less experienced surgeon: ₹150,000
Implant costs
  • Standard implant: ₹150,000
  • Premium implant: ₹250,000
Pre-operative tests and diagnostics
  • X-rays and blood tests: ₹20,000
  • MRI scan: ₹30,000
Post-operative care
  • Rehabilitation sessions: ₹30,000
  • Medication: ₹10,000
Total Cost Range ₹180,000 - ₹800,000

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