In India a number of orthopedic procedures are available such as hip and knee joint replacement, the Illizarov technique, limb lengthening, Birmingham Hip resurfacing technique (which scores over conventional hip joint replacement surgery and is still unavailable even in the US) etc. Many hospitals in India specialize in latest techniques and treatments such as minimal invasive surgery, cartilage and bone transplantation, spine surgery and limb sparing surgery. All kinds of muscular- skeletal problems ranging from Arthritis to sports injuries, to complex broken bones, bone tumors and childhood conditions like scoliosis are treated most effectively in India at costs much lower than in USA and UK. What is a Shoulder Joint Replacement Surgery?
In this surgical procedure, the shoulder joint is replaced with artificial parts. The type of surgery done will depend on the extent and type of injury. In some cases the surgeon may replace just the ball of the shoulder joint (the humeral head). This type of surgery is called a hemiarthroplasty. A surgeon may recommend a total shoulder joint replacement where the entire ball and cap (glenoid) are replaced.
Shoulder Joint replacement surgery is considered when:
1.The arthritis is a major problem for the patient,
2.The patient is sufficiently healthy to undergo the procedure,
3.The patient understands and accepts the risks and alternatives,
4.There is sufficient bone and tendon to permit the surgery, and
5.The surgeon is experienced in shoulder joint replacement surgery.
Shoulder Joint replacement is most effective when the patient follows a simple exercise program after surgery. Thus, the patient's motivation and dedication are important elements of the partnership.
Before Shoulder Joint Replacement Surgery:
Most degenerative problems will finally require replacement of the painful shoulder with an artificial shoulder joint replacement. The decision to proceed with surgery should be made jointly by patient and the doctor only after patient feel that he understand as much about the procedure as possible. Once the decision to proceed with surgery is made, there are several things that may need to be done. Orthopaedic surgeon may suggest a complete physical examination by patient’s medical or family doctor. This is to ensure that patient is in the best possible condition to undergo the operation. Patient may also need to spend time with the physical therapist that will be managing patient’s rehabilitation after the surgery. The therapist will be able to begin the teaching process before the surgery to ensure that patient is ready for the rehabilitation afterwards. The physical therapist will record a baseline of information. This includes measurements of patient’s current pain levels, functional abilities, the available movement and strength of each shoulder. A second purpose of the preoperative visit is to prepare patient for upcoming surgery. Patient will begin to practice some of the exercises, which he will use just after surgery. Finally, an assessment will be made of any needs patient may have at home once patient is released from the hospital. On the day of surgery, patient will probably be admitted to the hospital early in the morning. Patient will be instructed to not eat or drink anything after midnight the night before surgery. Patient should plan on being in the hospital for at least one or two nights following surgery. As with any medical treatment, individual results may vary. Only an orthopaedic surgeon can determine whether an orthopaedic implant is an appropriate course of treatment. There are potential risks, and recovery takes time. The performance of the new joint depends on weight, activity level, age and other factors. These need to be discussed with the doctor.
Procedure of Shoulder Joint Replacement Surgery:
General anesthesia is used most commonly during shoulder joint replacement surgery. The incision is 3 - 4 inches long and is made on the front of the shoulder from the collarbone (clavicle) to the point where the shoulder muscle (deltoid) attaches to the upper arm bone. This area of patient’s arm is rich in nerves and blood vessels and surgeon will have to be very careful while performing the procedure of shoulder joint replacement. Patient’s upper arm bone (humerus) will be dislocated from the socket to expose the ball-like end of patient’s upper arm. The portion of patient’s bone covered by articular cartilage is removed. The cavity of the joint will be cleaned and enlarged to create a hollow that matches the shape and size of the implant stem. The head or the rounded surface of the humerus will be cleaned and an appropriate size of the artificial ball will be selected and attached. If the socket is damaged, surgeon will implant the glenoid component as well to replace the socket during shoulder joint replacement. The surgeon prepares the socket surface by removing the remaining damaged cartilage. The plastic component is then fitted into the socket surface and cemented into position. Surgeon reattaches the supporting tendons and closes the incision. Patient’s arm will be placed in a sling and a support pillow will be placed under the elbow to protect the repair. A drainage tube will be inserted to remove excess fluids. The drainage tube will be removed on the next day of the Shoulder Joint Replacement surgery. The shoulder joint replacement surgery may last any where from 3 - 4 hours.
What to expect during the recovery period of Shoulder Joint Replacement?
A carefully planned rehabilitation program customized to patient’s needs is very critical for quick and successful recovery following shoulder joint replacement surgery. Physical therapy will be initiated in the next few hours after the shoulder joint replacement surgery. Physical therapy will consist of passive-assisted exercises for the range of motion at the shoulder joint. Patient’s therapist will train patient on how to use the pulley device to help bend and extend patient’s arm. Wear a sling all the time for at least one month after the shoulder joint replacement surgery. Bring loose fitting clothing, which will make it easier for patient to change and dress himself. Complete recovery of range of motion (depending on how stiff patientr shoulder joint was) before the shoulder joint replacement surgery returns in 2 - 3 months. Formal physiotherapy and occupational therapy may be required for the first 6 weeks after the shoulder joint replacement surgery. After that, patient’s rehabilitation program can continue at home. Patient may need to do these exercises several times a day for the next 4 - 6 weeks after the shoulder joint replacement surgery.
Possible benefits of Shoulder Joint Replacement Surgery:
When combined with a good rehabilitation effort, shoulder joint replacement arthroplasty allows arthritic shoulders to regain some of their lost comfort and function. In experienced hands, this procedure can address the restricting scar tissue that frequently accompanies arthritis. It can also restore smooth, stabilizing joint surfaces when these surfaces have been damaged by arthritis.
Joint replacement surgery can improve the mechanics of the shoulder, but cannot make the joint as good as it was before the onset of arthritis. In many cases, the tendons and muscles around the shoulder have been weakened from prolonged disuse before the shoulder joint replacement. The scar around them needs to be removed. After the surgery, it may take months of gentle exercises before the shoulder achieves maximum improvement.
The effectiveness of the procedure depends on the health and motivation of the patient, the condition of the shoulder, and the expertise of the surgeon. When performed by an experienced surgeon, the published literature shows that shoulder joint replacement arthroplasty usually provides improved shoulder comfort and function. The greatest improvements are in the ability of the patient to sleep, to perform activities of daily living, and to perform non-contact recreational activities.
Why go to India for Shoulder Joint Replacement Surgery?
Now, getting the Shoulder joint replacement surgery in India could be highly beneficial due to highly reduced costs and extremely good medical care available. More and more western patients seeking surgery are looking towards eastern destinations such as India, for their medical needs, including orthopedic procedures. The healthcare sector in this region has become a flourishing industry. As patients from Europe, the US and other affluent nations with high medical costs look for effective options, strong competition in the region among India, is seen as increasingly favorable with their state of the art hospitals, salubrious climate and tourism appeal. Attractive and affordable medical packages have now been developed to include: airfare, surgery, meals and five star accommodations with an additional site-seeing option. With a large pool of highly trained doctors, well-equipped facilities and minimal wait time at dramatically low prices, India aims to expand its outsourcing campaign to include the healthcare sector. Each year, 20-30,000 newly qualified medical professionals are available to offer their expertise in India. Foreign patients are exceptionally well cared for by a large staff of medical professionals, most of whom received training in the US and Europe.
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