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When shoulders develop severe arthritis, range of motion decreases and the ability to perform many daily activities becomes limited. Shoulder injections and therapy can temporarily help arthritis symptoms, but some patients may require a shoulder replacement to regain their function and independence. Shoulder replacements are the fastest growing subset of replacements in the US. Since 2009, JIS Orthopedics has been intimately involved in the development of total shoulder implants, patient-specific techniques, and post-operative recovery protocols.

Anatomic total shoulder replacement

The traditional or “anatomic” shoulder replacement involves reconstructing the shoulder joint in a manner similar to the normal anatomy. This includes a ball-like implant on the humerus and a socket-like implant on the glenoid. For an anatomic shoulder replacement to function normally, the rotator cuff must be intact and pre-operative motion must be acceptable.

Reverse total shoulder replacement

In patients with shoulder arthritis who have a torn, irreparable rotator cuff tear or severe joint destruction, a reverse total shoulder replacement is needed. This type of shoulder replacement allows for the larger deltoid muscle to take over some of the function of the deficient rotator cuff and the reverse implant has more rigid materials for poor bone quality patients. Reverse total shoulder replacement is becoming more common in the US and has a great track record. The reverse total shoulder replacement places a ball-like implant on the socket of the shoulder and cup on top of the humerus. Therefore, the anatomy is “reversed” in order to keep the ball and socket together with more stability.

Less invasive shoulder implants

Since 2015, less invasive “stemless” shoulder implants have become available after many years of success in Europe. These “stemless” implants do not penetrate deep into the humerus and are bone preserving. Not every patient is a candidate for these implants, and they cannot be used with the “reverse” total shoulder replacement. At JIS Orthopedics, we all believe in minimally invasive surgery and will use the least invasive implant possible for a successful long-lasting outcome.

Patient-specific total shoulder replacement

One of the most exciting developments in total shoulder replacements has been the utilization of patient-specific techniques to improve position of the replacement. In this scenario, a pre-operative CT scan is used to create a patient-specific “guide” that helps the surgeon place the shoulder implant in the perfect position for the patient. The theory is that better replacement position may lead to better function and longer implant survival. Not every patient is a candidate for this technology, but your surgeon will evaluate you for all options that will lead to improved outcomes and implant longevity, including patient-specific technology like this. JIS Orthopedics was the first practice in the US to use this technology and was integral in its development.

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