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