MINIMALLY INVASIVE SHOULDER REPLACEMENT
Copeland Total Shoulder

From pushing to pulling, lifting to throwing, the shoulder enjoys the widest range of motion.  Fortunately, for many, the shoulder is also one of the least likely joints that develop arthritic conditions requiring surgery.  However, certain conditions such as osteoarthritis and rheumatoid arthritis can require replacement surgery to restore pain-free movement to the shoulder.

This article will provide basic information on the anatomy of the shoulder, common reasons for shoulder replacement surgery, and the Copeland™ Minimally Invasive shoulder replacement. It is for educational purposes only and is not intended to replace the expert guidance of your orthopedic surgeon.  Any questions or concerns you may have should be directed to Dr. Rogerson at (608) 231-3410.

Shoulder Replacement Surgery
Shoulder replacement surgery can be an extremely successful surgical procedure.  The first shoulder replacement was performed over 50 years ago.  About 20,000 shoulder replacement surgeries are performed each year in the United States alone.

Anatomy
The shoulder joint contains the head of the humerus (upper arm bone) and the scapula (shoulder blade).  The head of the humerus rides against the scapula in a tiny impression called the glenoid, much like a golf ball on a tee.  The smaller size of the glenoid is what allows the large range of motion of a healthy shoulder.

The surfaces of the humerus and the glenoid are covered with a smooth tissue called cartilage.  The cartilage provides near frictionless, pain-free movement of the shoulder joint.  Osteoarthritis results from wear and tear that develops over years of movement and stress on the surfaces of the joint.  As the cartilage continues to wear away, the joint becomes increasingly painful and difficult to move.  Unfortunately, cartilage does not have the ability to repair or replace itself like other tissues in the body.  Once your cartilage is damaged or destroyed, it's gone for good. It is at this point that your surgeon may recommend shoulder resurfacing surgery.

Minimally Invasive Shoulder Resurfacing Every joint replacement candidate has a varying amount of cartilage damage in the affected joint.  Traditional total shoulder replacement uses a stem and ball made from a metal alloy such as titanium or cobalt chromium.  The stem is inserted into the upper arm bone and the ball replaces the head of the humerus. The glenoid is often resurfaced with a durable medical-grade plastic, called polyethylene.

The Copeland™ implant's design allows patients to potentially recover more quickly and with less pain.  The Copeland™ Humeral Resurfacing Head is also potentially less complicated to replace should future revision total shoulder replacement procedures become necessary.

Complications
While uncommon, complications can occur during and after surgery.  Some complications include infection, implant breakage, nerve damage, and fracture.  Although implant surgery is extremely successful in most cases, some patients still experience pain and stiffness.  No implant will last forever and the patient's post-surgical activities can affect the longevity of the implant.  Be sure to discuss these and other risks with your surgeon.

There are many things that your surgeon may do to minimize the potential for complications.  Your surgeon may have you see a medical physician before surgery to obtain tests.  You may also need to have your dental work up to date and may be shown how to prepare your home to assist in your recovery.

After Surgery
After surgery, you will probably be hospitalized for one to two days.  On the day after surgery, the bandages are removed and you begin light physical therapy to restore motion and promote blood flow to your joint.  You will wear a sling for up to six weeks after surgery to protect the soft tissues in your shoulder while they are healing.  During this time, a physical therapist will teach you a variety of exercises that will help restore motion to your shoulder.  Many patients are prescribed exercises that are performed three to four times a day for brief 10-15 minute sessions.

As you regain shoulder motion, you may start using light weights or large rubber bands in your physical therapy to help build strength.  Your doctor will determine the condition of your shoulder before prescribing strengthening exercises.

Every person's recovery time will vary, but most people should be able to drive in two to six weeks, garden in two months, and golf in three months.  Your surgeon will tell you when you can return to these activities and will also tell you which activities to avoid.

Is the Copeland™ Humeral Resurfacing Head Only for People with Osteoarthritis?
There are several reasons for the Copeland™ implant including rheumatoid arthritis, traumatic arthritis, and correction of deformity.  Patients must have a functioning or reconstructable rotator cuff to be candidates for the Copeland™ implant.

What Type of Rehabilitation Can I Expect Following Surgery?
Exercise is necessary for proper healing and for regaining motion and strength.  Most surgeons will recommend passive arm movements within 48 hours after surgery.  Physical therapy will begin in the hospital and continue after discharge for approximately six to eight weeks.  Your surgeon will then prescribe exercises for you to perform on a regular basis.

How Often Will I See My Surgeon After Surgery?
Your surgeon will set a follow-up schedule for the first year after surgery to evaluate your progress.  Your surgeon will most likely want to see you every year or two thereafter.  Complications can occur with implants, so seeing your surgeon when you notice a change in symptoms can assist in evaluating any changes that may occur with your new joint.

Closing
We know the decision to have surgery is sometimes difficult.  We hope this article has helped you understand some of the basics of minimally invasive shoulder resurfacing surgery so that you can make the best decision for yourself.  This article is not intended to replace the experience and counsel of your orthopedic surgeon.  If you have questions about the Copeland™ Humeral Resurfacing Head or minimally invasive surgery, please contact our office at (608) 231-3410.

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3/1/2006

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