To revise or not to revise?
The decision to undergo revision total shoulder replacement surgery requires a thorough patient history and physical examination. The orthopedic shoulder specialists at The Shoulder Clinic of Idaho may request additional imaging, such as an MRI or CT Scan to accurately assess the shoulder joint problem. It is also common that laboratory studies will be obtained – and possibly a shoulder aspiration or biopsy – to rule out infection. The shoulder surgeons will take the following into consideration:
- Is an infection present in the shoulder joint?
- A shoulder infection in the setting of a shoulder replacement procedure is an important concern. This may require antibiotics and may or may not require a revision shoulder replacement. Removal of the prosthesis is not always necessary, but is common if the infection is deep and adjacent to the shoulder prosthesis. Some infections may require multiple surgeries to cure them. They may also some times require the provisional placement of a shoulder joint spacer – or temporary shoulder replacement – which is later removed once the infection has been adequately treated.
- Is the shoulder joint unstable?
- If the shoulder joint is unstable, the cause must be identified and rectified. Instability can be caused by poor alignment of the shoulder prosthesis, loosening of the shoulder prosthesis, fracture, torn tendons, or altered anatomy.
- Is the new joint worn?
- Wearing of the plastic bushing and prosthetic joint surface can occur over time which can lead to pain and loosening of the shoulder replacement. These concerns need to be evaluated by a shoulder specialist so that a mechanical solution to the problem can be identified.
- Has the joint loosened since the total shoulder replacement?
- If the shoulder joint has loosened after the shoulder replacement, the orthopedic shoulder surgeons at The Shoulder Clinic of Idaho will consider the patient’s age, rotator cuff status and available bone stock before deciding on the type of revision needed.
- How is the rotator cuff?
- A torn or damaged rotator cuff can cause pain, weakness or a catching sensation in the shoulder joint and may require a revision total shoulder replacement. A torn rotator cuff tendon – or nonhealing of a tendon – may also contribute to instability of the shoulder replacement which could contribute to the need for revision shoulder replacement.
The main goal of a revision total shoulder replacement is to alleviate pain, stiffness and increase range of motion. Patients who have had a total shoulder replacement but are experiencing pain, functional deficits or loss of range of motion should be evaluated by one of the orthopedic shoulder specialists at The Shoulder Clinic of Idaho. They can diagnose and treat shoulder pain and have been successfully treating patients in Boise, Meridian, Nampa, and the surrounding communities of the Treasure Valley.
If you are suffering from pain, stiffness and loss of motion after a total shoulder replacement, you may need a revision surgery. To discuss your unique case or to receive more information about revision total shoulder replacement, please contact the orthopedic shoulder surgeons at The Shoulder Clinic of Idaho, serving patients in Boise, Meridian, Nampa, and the surrounding communities of the Treasure Valley.