Shoulder arthroplasty - time for a new joint!
- Mar 29
- 4 min read
Updated: 2 days ago
If all measures fail to address painful joint wear, an artificial shoulder joint is a reliable option!
In this article you will learn:
These are the goals of an artificial shoulder joint.
This is especially true with an artificial shoulder joint.
This is something to keep in mind when having an artificial shoulder joint.
In these cases, an inverse shoulder prosthesis is useful
What is the goal of an artificial shoulder joint?
The goal of an artificial shoulder joint is to restore quality of life and mobility in cases of shoulder wear or fracture. A worn shoulder joint is characterized by cartilage deterioration and bony deformities (osteophytes). This typically leads to pain and limits mobility. Over time, the joint space in the shoulder becomes increasingly narrow. This negatively impacts shoulder mobility and quality of life.
The implantation of a shoulder prosthesis improves shoulder mobility and eliminates pain. This initially involves a targeted diagnostic assessment, including a medical history, a manual examination of the shoulder, and X-rays. In some cases, an MRI scan may be appropriate, for example, to determine whether the rotator cuff tendons are still intact.
Once the diagnosis is made, the appropriate artificial joint can be selected.
What makes an artificial shoulder joint so special?
Artificial shoulder joints have been successfully used for many years. The first implants were developed in the early 1950s to replace worn and broken shoulder joints. At that time, artificial joints were only available in sizes S, M, and L, like a sweater, and could only mimic the actual shoulder anatomy to a very limited extent.
Modern shoulder endoprosthetics, on the other hand, makes it possible to replicate the individual anatomical and biomechanical aspects of the human being through individual components.
Computer-assisted implantation of artificial shoulder joints using patient-specific CT data, navigation, and robotics is gaining increasing importance. A precisely implanted artificial joint utilizes the full potential of this technology and leads to convincing results and satisfied patients.
This is what you should pay attention to when choosing the "right" artificial joint.
Artificial shoulder joints consist of biocompatible metal implants made of titanium or cobalt-chromium alloys.
If the humeral head is mainly affected by arthrosis, for example as a result of a fracture of the humeral head, and the joint socket still has a good cartilage covering and no significant deformation, it is usually sufficient to replace only this part of the joint with an endoprosthesis.
The surface of the humeral head is removed and fitted with a stemless prosthesis. This procedure largely preserves the natural bone. There is no need for anchoring the prosthesis with a long stem in the bone of the humerus.
Replacement of the socket is also possible. If the humeral head and socket show severe cartilage damage and significant deformity, both joint components should generally be replaced. This is then referred to as a total shoulder arthroplasty.
The short stem of the prosthesis is securely anchored in the bone of the upper arm. In most cases, the socket replacement is cemented into the bone via pins or a keel on the back of the socket.
Various types of cups are used to treat acetabular osteoarthritis. Cups made of highly cross-linked polyethylene (PE) with cement are typically used. PE cups with a fan-shaped central peg can be implanted almost cementlessly thanks to bone relining, as the central peg grows into the bone. A distinction is made between cups with keel and peg anchorage.
For special indications involving advanced bone wear, cementless titanium cups with a polyethylene insert can also be used. These cups are convertible. Should further joint wear occur after many years, these cups can be converted to an inverse system.
If, in addition to arthrosis, there is extensive damage to the rotator cuff, so that movement of the arm is only possible to a limited extent, a special endoprosthesis may be necessary.
This implant does not rely on the rotator cuff for joint movement and is called an inverse (reverse) endoprosthesis. Unlike an anatomical prosthesis, the ball is anchored to the joint socket.
The biomechanical principle of the reverse arthroplasty is to shift the center of rotation around which the inverted humeral socket can rotate. The deltoid muscle can compensate for the lack of strength development in the damaged rotator cuff, allowing the arm to be raised again.
The ball is anchored in the socket using cementless screws. In the upper arm, the endoprosthesis is inserted cementless if the bone quality is good. A polyethylene sliding cup is pressed into the upper part of the upper arm endoprosthesis, which can then slide around the head.
The reverse endoprosthesis is usually used in patients aged 65 and older. The prerequisite is intact deltoid muscles.
Prof. Ockert interviewed as an expert on artificial shoulder joints in the Münchner Merkur.
In a special edition of the Münchner Merkur newspaper, Prof. Ockert was interviewed by journalists as an expert on artificial shoulder joint replacement. He answered questions about the use and procedure of such a procedure.
"A prosthesis is not appropriate for every patient. However, with the right indication, it can reduce pain, improve mobility, and enhance the quality of life."
Conclusion:
Modern shoulder endoprosthetics, on the other hand, makes it possible to replicate the individual anatomical and biomechanical aspects of the human being through individual components.
In the upper arm, the endoprosthesis is inserted without cement if the bone quality is good.
The inverse endoprosthesis is usually used in patients aged 65 and over.
Computer-assisted implantation of artificial shoulder joints using patient-specific CT data, navigation and robotics is becoming increasingly important.
If you have any questions, please schedule an appointment with our shoulder specialist :
Specialist in orthopedics
and trauma surgery,
Sports medicine
