Osteoarthritis
Osteoarthritis is
the most common chronic degenerative joint disease. Its characteristics
are continuous loss of cartilage and deformation of the joint
surfaces. The classic symptoms are pain at rest and during or
after activities. The patients need analgetic and antiinflammatory
medication. The gradual loss of the range of movement is caused
by the narrowing of the joint spaces and the development of bony
appositions. This process can lead to almost complete stiffness.
Finally, conservative treatment like physiotherapy or injections
are useless and even arthroscopic interventions cannot improve
pain and joint function any more at this stage.
We have seen a tremendous evolution for partial and total
joint replacement of the shoulder over the last ten years.
While total hip and knee replacement are very well established
and a matter of daily routine in orthopaedic centers, joint
replacement of the shoulder is still a sophisticated procedure
and technically very demanding. However in advanced orthopaedic
centers, excellent surgical skills will be combined with
all the know-how and the latest technical equipment, which
is needed for replacement of the shoulder joint. The replacement
of the destroyed joint surfaces, either of the humeral head
alone or in combination with the glenoid surface, is an
excellent option in terms of pain relief and joint function.
For the best possible result optimal timing of the operation
is very important. Though it is possible to achieve good
results even in late stages, patient and physician should
not wait until the joint has ended up in complete stiffness
and destruction of all the surfaces. Beside a degenerative
disease like osteoarthritis some other pathologies like
rheumatoid arthritis, osteonecrosis of the humeral head
and severe forms of humeral head fractures may lead to joint
replacement with high chances for a satisfactory outcome.
For the specific needs of different diseases various prosthetic
components are available.
After an intial stay of 4 to 5 days in the hospital the
patients are transferred to a rehabilitation center where
they are treated as in-patients during 3 to 4 weeks. After
this period of time physiotherapy is continued on an out-patient
basis by specialized therapists. During the early postoperative
phase the patients should wear a soft shoulder support which
gives some protection against pain and mechanical stress.
The after-treatment is always functional and begins at the
first day after the intervention. The exercises for increased
joint mobility will be intensified after 2 weeks, ideally
as aqua therapy. Beside the specific physiotherapy, exercises
for muscular reinforcement are started very early. All the
patients are seen by their surgeon regularly. The whole
team is devoted to a closed team work between surgeon, therapist
and patient, which is mandatory for the best possible outcome
of joint mobility, muscular strength and pain relief.
(see pictures)
Info to download (117,6 KB)
