Shoulder resurfacing as an orthopedic procedure that is used as an alternative to total shoulder replacement surgery. Instead of replacing the entire shoulder joint, shoulder resurfacing involves “smoothing out” the spot where the upper arm bone (humerus) and shoulder blade (scapula) meet (the glenohumeral joint). The “ball” of the upper arm bone is replaced by a prosthesis, but the patient’s natural shoulder blade bone is left in place. A shoulder resurfacing surgeon may also use specialized surgical instruments to remove abnormal tissue from the spot on the shoulder blade that makes contact with the upper arm (glenoid).
Shoulder resurfacing is a more conservative surgical procedure than total shoulder replacement and is associated with fewer complications. A shoulder resurfacing doctor in New York City (NYC, Staten Island, Jersey City) will typically offer the procedure to relatively young, active people as a way to relieve chronic shoulder pain caused by bone or joint diseases.
People who ultimately have shoulder resurfacing surgery usually experience chronic shoulder pain due to problems at the glenohumeral joint. They may have stiffness at the shoulder joint that makes moving the arm difficult or painful. In most cases, a shoulder resurfacing surgeon will use the procedure as a treatment for osteoarthritis or posttraumatic arthritis. Shoulder resurfacing is also used to treat a condition called avascular necrosis. In avascular necrosis, blood does not flow properly to the upper arm bone, causing bone tissue to die.
Your local shoulder resurfacing doctor (New York City, Jersey City, Staten Island) will take a thorough history and perform a detailed physical evaluation to determine the cause of your chronic shoulder pain. The physician will order certain radiographic tests such as an X-ray or MRI of the shoulder. Your shoulder resurfacing doctor may prescribe nonsurgical, conservative therapies before moving on to shoulder resurfacing or total shoulder replacement. However, if you have already tried conservative therapies and these have failed, it is more likely for your shoulder resurfacing surgeon to recommend surgical treatment for your shoulder pain.
Three orthopedic surgery procedures can be used to treat chronic shoulder pain:
- Ream-and-run – The head of the upper arm bone is replaced with a metal ball. The person’s natural socket (glenoid) is reshaped to match the curvature of the metal ball.
- Hemiarthroplasty – Similar to a ream-and-run in that the head of the upper arm bone is replaced with a metal ball. However, in hemiarthroplasty, the person’s natural socket is not reshaped to match the curvature of the ball.
- Total shoulder replacement (arthroplasty) – The head of the upper arm bone and the socket of the shoulder blade are replaced.
- The HemiCAP® implant is utilized by your shoulder resurfacing doctor in Staten Island to facilitate matching the contour and shape of your shoulder’s cartilage surface. Basically, the HemiCAP® is a state-of-the-art patch for damaged cartilage in the shoulder designed to protect healthy tissues so that further damage is avoided.
- Approved for disabled shoulder joints caused by avascular necrosis or post-traumatic degenerative disease, the HemiCAP® system consists of 3-D mapping technology, specialized instruments to assess and prepare affected areas and a cobalt-chrome CAP mated to a titanium post and UHMWPE (polyethylene) tibial implant.
- By precisely aligning the implant’s surface to the contours of your shoulder cartilage surface, the HemiCAP® implant can successfully fill defects and restore a continuously smooth articular surface. Created to allow people to maintain an active lifestyle without interfering with future treatments, the Shoulder HemiCAP® System is highly recommended by a shoulder resurfacing doctor in Jersey City for patients who do not need total shoulder replacement surgery.
- Clinical studies investigating the efficacy of the HemiCAP® implant have demonstrated positive outcomes, with patients reporting quick recovery times, pain relief and restoration of range of motion. Performed as an outpatient procedure, the Shoulder HemiCAP® System not only works to preserve healthy bone and tissue, but also maintains your normal joint biomechanics so you can return to your daily activities as soon as possible.
Avascular necrosis (osteonecrosis) is bone tissue death due to lack of an adequate blood supply. Bone fractures, joint dislocation and long-term use of cortiscosteroids can interrupt blood flow to the shoulder and cause avascular necrosis. Reduced blood supply may also stem from fat deposits clogging blood vessels or diseases such as Gaucher’s disease or sickle cell anemia known to restrict blood flow. Although avascular necrosis may affect people of any age, it is often diagnosed in those between 30 and 60 years old.
If your shoulder resurfacing doctor in Jersey City diagnoses you with avascular necrosis of the shoulder, he may recommend having the HemiCAP® implant procedure done to preserve healthy bone and tissue as well as optimal functioning of your shoulder. Tests needed to correctly evaluate an avascular necrosis condition include x-rays, imaging tests such as CT and MRI scans and possibly a bone scan. Safe and extremely effective for diagnosing bone diseases, bone scans involve injecting a substance into your vein so that injured areas of the bone show up clearly on imaging plates.
How long will the HemiCAP® implant last?
Your surgeon expects the devices to last as long as similar metallic devices but it will depend on your general health, activity level, and adherence to your doctor’s orders following surgery. Currently over 30,000 patients have been treated with Arthrosurface® implants.
What happens if it fails?
If it ever fails, it can be replaced with another HemiCAP® device or, if necessary, it may be converted to a joint replacement.
Does it “burn any bridges?
Compared to existing joint replacements there is mini- mal bone loss with the HemiCAP® implant. With a joint replacement, the entire bony surface, sometimes even both sides of the joint, are surgically removed to facili- tate the implant being placed. This means there is far less of the natural bone to work with if future surgery is required. The HemiCAP® system leaves more bone intact therefore leaving more options should future surgery be required.
Will I feel it?
No. The implant is surgically placed so there are no protruding edges. The bone and the implant become a smooth surface you will not feel.
Will it set off airport security alarms?
It should not. However after receiving the HemiCAP® implant you can ask your surgeon to give you an implant identification card (similar to your driver’s license) that can be shown to anyone should there be any question.
How long will I be off of work?
This will be dependent on your muscle strength, range of motion and the type of work you do. Many patient’s have experienced a rapid return to daily activities. However, as with all medical treatments, your results may vary.
What type of physical therapy will I need to do?
Your doctor and therapist will design a rehabilitation protocol to return strength to your muscles so that you can return to your original lifestyle.
People recover from shoulder resurfacing surgery much more quickly and easily than would if they had total shoulder replacement. That said, post-surgical physical rehabilitation could still take up to 12 weeks. You will wear an arm sling for much of the first four weeks, especially at night. After the first month, you will be able to use your arm as you did before, though you should protect it from jarring or traumatic activities (e.g. a slap on the back).
Once your shoulder has fully healed, your shoulder resurfacing surgeon will “okay” you to return to full activity. Indeed, once your arm has healed, you should expect to be pain free and able to do all the things you were able to do before your shoulder pain started.
If you have chronic shoulder pain and are interested in shoulder resurfacing surgery, contact the professionals at Regional Orthopedics. Our shoulder resurfacing surgeons have convenient locations across New York City (NYC, Staten Island, Jersey City).