Reverse shoulder replacement restored mobility to a 71 year old lady afflicted by Rheumatoid arthritis.
A complex Reverse Shoulder Replacement procedure was undertaken on an Odisha patient at a city-based hospital helping restore mobility. In a release here today, Dr AK Venkatachalam, who specializes in joint replacements and arthroscopy, said Ms P Nair from Bhubaneshwar of Odisha had been suffering from left shoulder pain for the last 15 years due towidespread rheumatoid arthritis. She could not get any relief from Ayurvedic treatment. CT and MRI scans showed advanced bone and soft tissue destruction from the rheumatoid arthritis.
Rheumatoid arthritis affects all the synovial joints ultimately leading to joint damage and bony destruction.
As the bony destruction was advanced, Dr A K Venkatachalam decided on the basis of the scan reports to perform a Reverse Shoulder Replacement “which was her only option.”
He performed the surgery that took nearly two and half hours.
Earlier in 2008, he had performed bilateral knee replacements to help her to walk. In a reverse shoulder replacement, the surgeon is faced with extensive damage to the rotator cuff, joint and bones. The rationale is instead of relying on the rotator cuff tendons to initiate movement, the surgeon relies on the Deltoid muscle to initiate lifting of the arm. The normal position of the ball in a shoulder joint is at the upper end of the arm bone while the socket is at the outer end of the shoulder blade. In this operation, the position of the two is reversed with the ball being shifted to the shoulder blade and the socket to the upper end of the arm bone. The center of rotation is shifted more outward and this makes the Deltoid muscle more effective, he claimed. The back side of the un-cemented ball is coated with a ceramic material to allow osseo-integration by the patient’s own bone. The ball will biologically integrate with her shoulder blade. The socket is cemented into the arm bone. He said the patient had recovered well and will be discharged in a day. She will be totally pain free and recover full mobility after a course of physical therapy, Dr Venkatachalam said.