Date post: | 07-May-2015 |
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Health & Medicine |
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UNDERSTANDING AND ADDRESSING
CHRONIC SHOULDER PAIN
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Do You Have Chronic Shoulder Pain?
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Are Your Daily Living Activities Limited?
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• Chronic Pain
• Compromised Shoulder Function
• Combination-both pain and compromised function
Symptoms
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Normal Shoulder: Bone Anatomy
Scapula (Shoulder Blade)
Clavicle
Humeral Head (Ball)
Humerus
Glenoid (Socket)
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Some Causes of Shoulder Pain & Compromised Function
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Arthritis
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Fracture
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Shoulder Dislocation
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How Do I Manage the Pain?
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• Non-surgical - • Lifestyle changes• Physical therapy• Medications• Injections
Short Term Treatment Options
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Shoulder Replacement may be
an option for you - 1. Primary total shoulder
replacement2. Reversed total shoulder
replacement3. Shoulder resurfacing
Long Term Solution
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Shoulder Replacement 3rd most common type of
joint replacement
Shoulder Pain – A Common Problem
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Studies prove that shoulder replacement is just as safe and effective in relieving pain
and restoring mobility as hip or knee replacement.
“In a study of patients with shoulder pain, more than 95% reported having less pain
after shoulder replacement.”
1 Farmer KW, Hammond JW, Queale WS, Keyurapan E, McFarland EG. Shoulder arthroplasty versus hip and knee arthroplasties: a comparison of outcomes.Clin Orthop Rel Res 2007;455:183-9.
Safe, Reliable, Effective Solution
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Talk with your surgeon to determine the best treatment option for you
Steps to a Solution
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Primary Total Shoulder Replacement
The Humeral Head (ball) is replaced with a stem and head prosthesis.
The Glenoid (socket) is replaced with a rounded, specialized plastic implant.
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Implanted Primary Shoulder Device
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Reversed Total Shoulder Replacement
A “Reversed” implant reverses the normal ball and socket configuration.
The humeral head is replaced by a stem and a plastic ‘socket,’ and the glenoid is replaced with a ball.
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Implanted Reversed Shoulder Device
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Normal Shoulder: Rotator Cuff
Anterior ViewSupraspinatus Muscle
Subscapularis Muscle
• Reversed Shoulder replacement is often an option for patients with compromised rotator cuff function
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Resurfacing Head
With humeral head resurfacing, a ‘cap,’ or a resurfacing head implant, is placed over the existing, damaged humeral head.
This relieves pain and restores function for some patients.
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Shoulder Replacement Device
Reversed Total
Primary TotalStem and Head
Glenoid
Keeled Glenoid
Reversed for
Fracture
Primary Total Press
Fit
Resurfacing Head
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75% of shoulder replacements are performed by general orthopedic surgeons, doing only 1-2 cases per year*
*Hasan SS, Leith JM, Smith KL, and Matsen FA, 3rd. The distribution of shoulder replacement among surgeons and hospitals is significantly different than that of hip or knee replacement. J Shoulder Elbow Surg 12: 164-169, 2003.
The Value of Shoulder Specialists
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Study showed direct correlation between surgeon volume and patient outcomes
*Nitin J et. Al. The relationship between surgeon volume and hospital volume and outcomes for shoulder arthroplasty. J Bone Joint Surg Am. 2004;86:496-505.
The Value of Shoulder Specialists
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– Are interactions with my current medications a concern?
– What kind of after surgery help will I need?
– Is there anything I can do in advance of surgery that will make the recovery process easier?
I’ve elected to have shoulder replacement…
Pre-Surgery Considerations
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– Performed in the hospital by an experienced, specialized surgical team
– An incision about 4-8 inches long is made in the front of the shoulder in order to receive the implant
– The site is prepared, necessary components are placed, and the incision is closed
– Generally takes 1-3 hours
Surgery: What to Expect
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Your recovery will be determined by your doctor:
– A hospital stay may or may not be required
– Most people are able to return to normal daily activities within the first two weeks
– Your physician will tell you when it is safe to drive (generally not until 6 weeks after surgery) and perform other tasks
Recovery: Post-Surgery
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Your rehabilitation program will be determined by your doctor:
– Critical to the success of your new shoulder
– Often begins as early as the day of your surgery
– Involves in-home exercises that must be followed exactly and done regularly
– May be required to obtain PT in the clinic
Recovery: Physical Therapy
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Recovery time varies with each patient, but on average,
total recovery time is approximately 3-
6 months.
Total Recovery Time
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Outcomes vary by patient, but can include:
– Decrease or elimination of pain
– Full or partially restored mobility
– Restful sleep
– Return to daily tasks and activities
Common Treatment Outcomes
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Although rare, some of the most severe complications associated with shoulder replacement are:
• Infection
• Dislocation
• Postoperative fractures
• Glenoid component failure
You should talk with your doctor about benefits and risks before proceeding with any treatment option.
As with any surgery, there is always a risk of complications.
Complications
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• Add a patient story from your practice, have a patient advocate present, play the Tornier Patient Testimonial DVD.
Patient Testimonial
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Achieve the goal of relieving pain and restoring function for your patients
“99% of the people who have a shoulder replacement for arthritis get pain relief and say that they wish they had done it sooner.”*
Overall Patient Satisfaction
1 Farmer KW, Hammond JW, Queale WS, Keyurapan E, McFarland EG. Shoulder arthroplasty versus hip and knee arthroplasties: a comparison of outcomes.Clin Orthop Rel Res 2007;455:183-9.
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– Am I a good candidate for this
surgery?– Will insurance cover it?– What outcome can I expect?– Are there any side effects or
complications?– Will I have pain?– How long is the recovery period?– What kind of help will I need?– What long-term restrictions will I
have?– When can I return to daily activities,
i.e. work, hobbies, volunteering…?
I need help deciding…
Key Decision-Making Considerations
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– Condition and quality of the bone
– Type and severity of arthritis
– Condition of the muscles around the shoulder
– Your age, activity level and overall health
– Your commitment to rehabilitation after surgery
Success Factors
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• You do not have to suffer from shoulder pain and compromised mobility
• Non-surgical and surgical treatment options
• You can have an improved
quality of life and return to your normal activities
You Don’t Have to Suffer!
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Questions & Answers
Thank You