23470 Arthroplasty, glenohumeral joint; hemiarthroplasty

Name of the Procedure:

Arthroplasty, glenohumeral joint; hemiarthroplasty
Common Name: Shoulder Hemiarthroplasty

Summary

In a shoulder hemiarthroplasty, the damaged parts of the shoulder joint are replaced with an artificial implant. Unlike a total shoulder replacement, only the head of the humerus (upper arm bone) is replaced, while the socket part of the joint remains intact.

Purpose

The procedure addresses severe arthritis, fractures, or damage to the shoulder joint. The goal is to relieve pain, improve joint function, and increase range of motion.

Indications

• Severe shoulder arthritis with significant pain and loss of function
• Complex fractures of the humeral head that cannot be repaired
• Avascular necrosis of the humeral head
• Previous unsuccessful surgical treatments
• Patients who have a healthy glenoid (socket) or minimal wear and tear

Preparation

• Patients may need to fast for several hours before the procedure.
• Preoperative medications such as blood thinners might need to be adjusted.
• Diagnostic tests, including X-rays, MRIs, or CT scans, are typically completed to assess the condition of the shoulder joint.
• Patients will undergo a preoperative health assessment to ensure they are fit for surgery.

Procedure Description

1. The patient is placed under general anesthesia or regional nerve block to ensure they are pain-free and comfortable.
2. An incision is made over the shoulder joint to access the humeral head and glenoid.
3. The damaged or diseased head of the humerus is removed.
4. The remaining bone is prepared, and an appropriate-sized prosthetic humeral head is fitted.
5. The prosthetic implant is secured in place either with or without cement.
6. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The entire procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital surgical suite or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection
• Blood clots
• Implant loosening or failure
• Nerve or blood vessel damage
• Stiffness or restricted range of motion
• Persistent or recurrent pain

Benefits

• Significant pain relief
• Improved shoulder function and range of motion
• Enhanced quality of life Patients typically experience improvements within weeks to months post-surgery.

Recovery

• Patients may stay in the hospital for a day or two post-surgery.
• Physical therapy usually starts shortly after surgery to aid recovery.
• A sling may be worn for several weeks to protect the shoulder.
• Full recovery and return to normal activities can take several months.
• Follow-up appointments are necessary to monitor progress.

Alternatives

• Total shoulder arthroplasty (replacement of both the humeral head and the glenoid)
• Shoulder resurfacing
• Conservative treatments like physical therapy, medications, or corticosteroid injections

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. Postoperatively, they may experience some discomfort and swelling, which is managed with pain medications. Physical therapy is crucial for optimal recovery, and patients are advised on specific exercises and activities to avoid during healing.