about the procedure
Rotator CuffRotator CuffThe rotator cuff is made up of four muscles and their tendons. These combine to form a "cuff" over the head of...-Tear Arthropathy (CTA) is an arthritic condition that occurs when people have a large rotator cuff tear for an extended period of time. It is the combination of a massive rotator cuff tear and the collapse of the surface of the upper arm boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... (humerushumerusThe bone of the arm, articulating with the scapula above and the radius and ulna below.). People with cuff-tear arthropathy typically experience severe painpainAn unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibe... and very limited movement.
Surgeons decide what procedure to use based on the extent of damage to the shoulder bones and surrounding tissues. Rotator cuff and orthobiologic implants repair more severely damaged shoulders. In a study of hundreds of patients who had shoulder surgerysurgeryThe branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipula..., more than 95% reported having less pain afterwards.1
shoulder anatomy
The rotator cuff attaches the shoulder to the upper arm and helps the arm move in a circular fashion. The ball and socket of the shoulder jointjointThe junction or articulation of two or more bones that permits varying degrees of motion between the bones. move smoothly if the cartilagecartilageThe hard, thin layer of white glossy tissue that covers the end of bone at a joint. This tissue allows motion ... stays healthy and the surrounding muscles, tendonstendonsFibrous bands, one at each end of a muscle, that connect the muscle to bones. and ligaments remain intact. However, disease, traumatraumaPhysical injury., or a lifetime of "wear and tear" can injure the rotator cuff and destroy underlying bones.
DePuy Global® Advantage Cuff-Tear Arthropathy (CTA) shoulder joint
When the rotator cuff muscles have been torn, and the shoulder joint has become arthritic and painful, it can be difficult to raise the arm above shoulder level. This condition is called cuff tear arthropathy. The DePuy Global Advantage CTA Humeral Head addresses the surgical issues related to this arthritic condition.
Another option, the DePuy Global AP CTA Shoulder provides the latest advancement in a trusted line of shoulder implants from DePuy that dates back decades. Each person‘s shoulder joint is as unique as he or she is. The variation from person to person is due to differences in size, shape and angle of the bones, as well as other natural variations. With the DePuy Global AP CTA Shoulder, a surgeon can choose the optimal shoulder implant to help reduce their patient‘s pain and restore the smooth, natural movement of the shoulder.
what are the components of a DePuy Global CTA shoulder joint replacement?
The DePuy Global Advantage CTA and DePuy Global AP CTA shoulder implants are designed to replace the ball portion of the shoulder joint called the humeral head. They attach to the top of a metal stem that fits into the upper arm bone (humerus), anchoring the implant in place.
what are the benefits of the DePuy Global Advantage CTA shoulder joint replacement?
One major problem with total shoulder replacement for cuff tear arthropathy is encountered when the rotator cuff tendons cannot be repaired. They have become too scarred and weakened to effectively raise the arm from the side. The DePuy Global CTA family of implants are designed to reduce friction, which may allow the deltoid muscle to raise the arm higher even when the rotator cuff tendons cannot be repaired.
The DePuy Global Advantage and the DePuy Global AP CTA shoulder implants are designed with a larger articulararticularOf or relating to a joint. surface, the area where the joint rotates, than a traditional shoulder replacement for a more natural fit and greater range of motion. As the deltoid muscle raises the arm, the implant surface remains in contact with the socket longer. This helps the deltoid raise the arm higher by itself.
Who is a candidate for CTA surgery with a DePuy Global CTA shoulder joint replacement?
- A DePuy Global CTA implant can be used in patients who have cuff tear arthropathy or rotator cuff tendons that cannot be repaired.
- In most cases, the surgeon will have a good idea that a CTA implant may be required in advance, but the decision may also be made at the time of surgery.
what is the DePuy Restore Implant?
The DePuy Restore orthobiologic implant is the first of its kind and has changed the treatment of soft tissue tears and damage. Developed through a partnership between Purdue University and DePuy, the Restore implant provides an absorbable brace to strengthen soft tissue repair.
The traditional treatment for reinforcing lost or damaged tissue has been transplanting bone or tissue. The DePuy Restore implant gives the surgeon a less invasive treatment when the rotator cuff tissue is of poor quality or the repair needs reinforcement.
While the body regenerates damaged tissues, the DePuy Restore implant reinforces the repaired soft tissue and provides a framework around which the body builds new tissue. As new tissue grows, the DePuy Restore implant slowly dissolves until all that remains is your tissue. The 10-layer thick implant is strong yet very thin and can easily be cut into any shape needed to repair the injury.
what is the DePuy Restore Implant made of?
The implant, derived from the lining of a pig's small intestine, has been cleansed, processed, and sterilized. The DePuy Restore implant was extensively tested for safety before being introduced. High level safeguards have been implemented to eliminate the potential for infection or disease transmission.
what possible complications should patients be aware of?
Reactions or rejection of the material could occur, particularly if the patient has a history of multiple or severe allergies, an overly sensitized immune system, or if the patient has a sensitivity to pork products. Keep in mind that soft tissue repair is surgery, and with any surgery there may be general adverse effects or complications. These include:
There are also a few related risks associated with Restore:
note
Only an orthopaedic surgeon trained in shoulder replacement can provide advice about whether shoulder replacement surgery is the option. Patients should consult with a physician to learn more. As with any surgery, there are risks, and results may vary depending on the patient‘s age, weight, activity level, preoperative condition and other factors. People with current infections or conditions limiting rehabilitation should not have this surgery. The most common adverse events after joint replacement are loosening, infection and fracture of the prostheses or bones. Patients and their surgeons must weigh the risks of surgery against its possible benefits.
adverse events
The following are the most frequent adverse events after shoulder arthroplastyarthroplastyExamination of a joint with a scope.: change in position of the component, loosening of components, dislocationdislocationDisplacement of an organ or any part; specifically disturbance or disarrangement of the normal relation of the..., infection, hematoma, pneumonia and cardiovascular disorders.
references
1 McFarland EG. Shrug off shoulder surgery myth, Johns Hopkins study suggests. Available at: www.jhintl.net/news/default.aspx?id=3086. Accessed on Feb. 27, 2009.
