Osteoarthritis of the shoulder, John Nutting, MD скачать в хорошем качестве

Osteoarthritis of the shoulder, John Nutting, MD

The primary function of the shoulder is to put your hand where you want it to go. Dr. Nutting reviews the anatomy of the shoulder, a ball and socket that looks similar to golf ball sitting on a tee. Ligaments, cartilage and muscles keep the joint in place and working well but can cause pain as well. X-rays help to show bones. Bone spurs often develop in the shoulder joint to help distribute the force over a greater area when you don't have any cartilage left. Frequently osteoarthritis in the shoulder gets worse with activity and can comprise your quality of life. Use surgery as the last resort -- always start with the least invasive treatment. First, avoid things that make it worse but don't completely stop your activities. Anti-inflammatory medications can help to reduce pain. Physical therapy can help to maintain your range of motion as much as possible but do not lift weights as that may cause more damage. The jury is out on the effectiveness of injections. Steroids seem to be most effective and are injected directly into the joint. How long they are effective depends on how much arthritis you have. Dr. Nutting recommends injections up to three times a year (every four months). The first injection will give the most relief with less relief each time. How do you decide when to have surgery? Timing is dictated by the patient -- primarily their pain level. If you can't do things you have to do because of pain that is the time to think about surgery. There is no convenient time -- you need to have a block of three to four months to get back to full function. If you opt for a total shoulder replacement, age is important because of longevity. Data shows that at 20 years 85% of patients are doing well. The later it is done the better. Dr. Nutting outlines activity level, expectations and risks as well. The most common issues of total shoulder replacement are loosening of the components and dislocation. Arthroscopy -- minimally invasive procedure -- is done when the surgeon wants to look at structures. It is most effective when the arthritis isn't all gone and you may only have cartilage that can easily be repaired or loose pieces that can be taken out. However, there is not much difference over an injection unless there are mechanical problems to fix. Hemiarthroplasty -- replacing half of joint -- does not provide as much pain relief a total joint replacement but it can provide some pain relief. Reverse total shoulder replacements are very popular; however, patients have to have a specific set of symptoms. Once this procedure is done, you will count on deltoid muscle rather than rotator cuff muscle to move the arm. The long term effects from that surgical approach are still not known. Total shoulder replacement is when both the ball and socket surfaces are replaced. Patient stay in the hospital for 48 hours and there is a larger incision. The joint becomes stronger over time. You will have a sling after surgery and will start physical therapy on morning after surgery. Patients can expect to be immobilized for four to six weeks and rehab can be done wherever you like according to our protocol. Most patients regain motion within the first three months then they can start strengthening. Learn more at: http://bit.ly/dh-osteo