about the procedure
When severe shoulder painpainAn unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibe... starts interfering with daily activities, it may be time to consider surgical options designed to provide pain relief and freedom of movement. Over 60,000 Americans have shoulder replacement procedures each year, many experiencing pain relief and improved function.1 An increasing number of patients are returning to more active lifestyles thanks to advancements in the materials and procedures used in shoulder replacement. Today, shoulder replacement is the third most common jointjointThe junction or articulation of two or more bones that permits varying degrees of motion between the bones. replacement.2 In a study of patients with shoulder pain, more than 95% reported having less pain after shoulder replacement.3
who is a candidate for shoulder replacement?
Patients may benefit from shoulder replacement if:
what makes up to a total shoulder replacement?
In total shoulder replacement surgerysurgeryThe branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipula..., the ball of the humerushumerusThe bone of the arm, articulating with the scapula above and the radius and ulna below. and socket of the scapula (glenoid) are replaced with specially designed components.
The humeral implant consists of a metal ball that replaces the head of the humerus, and a stem that is secured into the main arm boneboneThe hard tissue that provides structural support to the body. It is primarily composed of hydroxyapatite cryst... (humerus).
The humeral stem is made of titanium for maximum strength. The head is made of cobalt chrome to provide a smooth surface for movement with the glenoid component, which is made of medical-grade polyethylene.
The metal ball and stem are selected by the surgeon from multiple sizes to fit the contour and shape of each patient‘s humerus. This two-piece construction is known as a modular implant. This modularity allows surgeons to closely replicate the natural shoulder.
If the surgeon uses only the metal humeral components (humeral head and stem), the procedure is called a partial shoulder replacement. If the surgeon uses both the humeral components and the glenoid implant, the procedure is called a total shoulder replacement. Surgeons will decide which procedure to use based on the extent of damage to their patients‘ shoulders.
why DePuy shoulder implants?
Every day innovative orthopaedic solutions from DePuy help improve lives. What began over a century ago as the first commercial orthopaedicsorthopaedicsThe medical specialty involved in the preservation and restoration of function of the musculoskeletal system t... company in the U.S. is today a global leader in orthopaedic devices and supplies, including hip, knee, extremity, traumatraumaPhysical injury., cement and operating room products. DePuy shoulders are designed to closely reproduce the smooth, complex movement of the natural shoulder. That‘s why each DePuy shoulder implant is based on detailed studies of the shoulder, its structure and function to help you keep moving.
DePuy shoulders incorporate technologically advanced materials designed to resist the type of wear that typically occurs in shoulder joints. For example, Premieron™ cross-linked polyethylene, used to replace the shoulder socket (glenoid) and replicate the smooth cartilagecartilageThe hard, thin layer of white glossy tissue that covers the end of bone at a joint. This tissue allows motion ... surface reduces wear by 85% over traditional polyethylene.4 The less wear, the longer a new shoulder can be expected to last. However, all shoulder implants may need replacement at some point.
Why choose the DePuy Global® AP® Shoulder?
The DePuy Global AP Shoulder is 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 the person 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.
DePuy Global® AP® Adjustable Neck Shoulder System
With the DePuy Global AP system, the surgeon can adjust the shoulder implant to replicate the precise angles of each patient‘s natural alignment, which help restore the smooth, natural movement of the shoulder.
what are the possible benefits and risks?
The DePuy Global AP Shoulder is made of advanced metals and a high-tech cross-linked polyethylene specially designed for long-lasting durability. It is important to note that only an orthopaedic surgeon trained in total shoulder replacement can provide advice about whether total shoulder replacement surgery and the DePuy Global AP System are the right option. Individual results with any medical treatment may vary.
why choose the global advantage shoulder system?
The new shoulder must fit correctly or it won‘t be stable. If it doesn‘t fit, patients may not be able to move their arm and shoulder freely or notice less pain after surgery.5 Matching the size and type of the shoulder implant to each patient‘s body is one of your surgeon‘s most important jobs. The DePuy Global Advantage System has 31 different humeral head options, as well as 13 different glenoid components, allowing for a more precise match of the natural shoulder.
designed for Long-term stability
When people move their shoulder, the head of the arm bone rotates within and also travels across their shoulder socket, unlike the simpler back and forth motion of the hip or knee. Earlier shoulder replacement implants did not address this kind of complex multi-directional movement. The DePuy Global Advantage System is designed to recreate the subtle intricacies that are a part of the shoulder's natural motion.
reverse shoulder replacement
Reverse shoulder joint replacement is a procedure developed for those who have exhausted all other treatment options. When damage within the shoulder has reached advanced stages of shoulder weakness and pain, it may become necessary to make changes in the normal mechanics of the shoulder.
People who have severe musclemuscleContractile connective tissues that affect movement; a component of nearly all organs and body systems. weakening and loss of function may need to have their shoulder realigned through the reverse shoulder replacement procedure. In a normal healthy shoulder, the upper arm bone (humerus) ends in a ball shape. This fits into a socket formed by the shoulder blade (scapula). Together this ball and socket form the shoulder. With the Reverse Shoulder Replacement, the anatomy, or structure, of the healthy shoulder is reversed. The implant is designed so that the ball portion is attached to the scapula and the socket is placed at the upper end of the humerus.
Following the procedure, the stronger muscles in other parts of the shoulder are allowed to do the work of the joint as normally as possible. Also, the new mechanics of the shoulder and use of stronger muscles will hold the parts of the implant together more tightly than the injured shoulder could, thus making the joint more stable and less likely to dislocate.
Delta® XTEND Reverse Shoulder System
The Delta XTEND Reverse Shoulder has been used for over 15 years in Europe and has been in use since 2004 in the U.S. where it has demonstrated restored motion, pain relief, and stability when implanted by trained surgeons in the appropriate patients.7
Reversing the anatomy of the shoulder and using the healthy deltoid muscle can help restore some shoulder function in patients with end-stage cuff tear arthropathy, or a joint replacement that has failed with a grossly deficient rotator cuffrotator cuffThe rotator cuff is made up of four muscles and their tendons. These combine to form a "cuff" over the head of... joint.
what‘s the different about the DePuy Delta XTEND Reverse Shoulder System from traditional shoulder replacement?
The DePuy Delta XTEND Reverse Shoulder System consists of five components that change the orientation of the shoulder so that the shoulder socket (glenoid) is replaced with an artificial ball, and the normal ball (humeral head) is replaced with an implant that combines a socket and stem into which the artificial ball rests.
This design alters the normal mechanics of the shoulder and enables the implant to stabilizestabilizeTo hold securely in place. the joint and restore limited motion when the rotator cuff is damaged or significant bone loss has compromised it.
who is a candidate for surgery with the Della XTEND Reverse Shoulder?
The Delta XTEND System is designed for people who:
The Delta XTEND Reverse Shoulder is generally used in people who have significant pain and little or no movement in their shoulder. It is not recommended for people who have bone disease or deficiencies to the shoulder blade (scapula). A functional deltoid is necessary to use this implant. It is not recommended for patients who have expectations of returning to demanding physical activity.
The patient and surgeon must weigh the risks of surgery against its possible benefits.8
who should perform shoulder replacement surgery?
Any surgical procedure involves a certain amount of risk and should be entered into accordingly; shoulder replacement surgery is no different. Physicians who treat end-stage cuff tear arthropathy with a reverse shoulder replacement must be experienced shoulder arthroplastyarthroplastyExamination of a joint with a scope. surgeons.
Only an orthopaedic surgeon trained in shoulder replacement can provide advice about whether shoulder replacement surgery is the right choice. Patient‘s should consult with a physician to learn more. The performance of a joint replacement depends on age, weight, activity level and other factors. There are potential risks and recovery takes time. People with current infections or conditions limiting rehabilitationrehabilitationRestoration, following disease, illness, or injury, of the ability to function in a normal or near-normal mann... should not have this surgery. The most common adverse events after shoulder replacement are loosening, infection, and fracture of the implant or bone. The patient and surgeon must weigh the benefits of surgery against potential risks.
The following are the most frequent adverse events after shoulder arthroplasty: change in position of the components, 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.
1 US Markets for Small Joint Devices. Toronto: Millennium Research Group; 2007.
2 Joshi D. Total shoulder replacement—the 3rd most replaced joint in America! Available at: http://www.pearldiverinc.com/pdp/index.php. Accessed Jan. 27, 2009.
3 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.
4 Klotz C, Deffenbaugh DL, McNulty D, et al. Cross-Linked Glenoid ProsthesisProsthesisManufactured substitute for a diseased or missing part of the body.: A Wear Comparison to Current Glenoid Prostheses. Warsaw, IN: DePuy Orthopaedics, Inc.; 2006. Cat. No. 0612-00-585.
5 Iannotti J, et al. Total shoulder arthroplasty: factors influencing prosthetic sizing. Op Tech Orth. 1994:4(4); 198.
6 Iannotti J. Radiographic evaluation of a humeral stem designed for uncemented use. Data submitted as 2001 AAOS abstract.
7 Data on File at DePuy. http://www.myshoulderreplacement.com/DePuy/docs/Shoulder/Products/ Info/Delta_XTEND.html
8 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.