ADVANCES IN SHOULDER SURGERY
ADVANCES IN SHOULDER SURGERY CAN PUT TENNIS PLAYERS BACK ON THE COURT:
Dr.Kevin Plancher discusses options to relieve pain and restore young and old athletes' active lifestyles
(HealthNewsDigest.com).. NY and Greenwich, CT, March 20,2006 – Just a decade or two ago, loss of mobility in the dominant shoulder was a tennis player's permanent ticket off the court. Yet, a combination of new surgical techniques and methods that have been proven successful over the past decade is making shoulder surgery a good option for many "Baby Boomer" athletes eager to get back in the game.
"Many fit, active 'Boomers' are familiar with hip and knee replacement surgeries, which are fairly commonplace," says Kevin Plancher, M.D., a leading NY-area orthopaedist, sports medicine expert and official orthopaedic surgeon of the U.S. Ski and Snowboard teams. In fact, according to the American Academy of Orthopaedic Surgeons (AAOS), more than 700,000 Americans have hip or knee replacements each year, compared with just 23,000 shoulder replacements. But that number is on the rise. "Now, thanks to advances in techniques and technologies, shoulder sufferers have more options for treatment than ever before," Dr. Plancher explains.
Many tennis enthusiasts sidelined by shoulder trouble may be there due to osteoarthritis of the shoulder, a condition that can occur from overuse from overhead sports at a younger age or from a specific traumatic injury to the shoulder. "Many Baby Boomers who are candidates for shoulder replacement surgery have been playing overhead sports for decades," Dr. Plancher notes. "The shoulder is the most dynamic joint in the body, capable of a tremendous range of motion. In fact, it is the inherent instability in the shoulder that allows it to work so well, permitting athletes to throw and hit with such accuracy and speed."
Unfortunately, in overhead sports like tennis, micro-injuries to the joint can occur during every match, and their effects can build over years. These overuse injuries can eventually wear on the ball and socket of the shoulder joint, causing osteoarthritis to develop. Previous traumatic injury such as a shoulder dislocation can lead to chronic pain and limited motion over the long term. These weekend warriors might be great candidates for a total shoulder replacement, although new alternative techniques are also available.
Three Options for Troubled Shoulders
"Arthritis is seen more and more often among fit forty- and fifty-somethings, because Americans are becoming -- and remaining -- more active through their midlife and senior years," Dr. Plancher notes. "Fortunately, there are a number of options for those whose shoulder trouble is preventing them from resuming their active lifestyle," Dr. Plancher says.
"REAM AND RUN" HEMIARTHROPLASTY is an excellent alternative for many candidates with severe arthritis who may not need a total shoulder replacement. In this partial shoulder replacement, only the humerus (ball) is replaced, and the glenoid (socket) is resurfaced to make it smoother and to reshape it or reorient its direction, if needed. This procedure avoids the use of a plastic socket. "Partial shoulder replacement surgery can improve the longevity of comfort and a high level of shoulder function in patients with severe shoulder arthritis," Dr. Plancher explains. "The recovery of comfort may sometimes take longer than with conventional total shoulder arthroplasty."
PARTIAL REPLACEMENT WITH TISSUE- REGENERATION TECHNOLOGY is the newest approach in joint replacement, and it has shown promise for partial shoulder replacement as well as other joint surgeries. During this cutting-edge procedure, the surgeon can resurface the bone structures and replace deteriorated cartilage with new synthetic compounds that are designed to promote the body’s own healing within the joint, and dissolve away over time. “This type of partial shoulder replacement surgery is ideal for patients who would otherwise need bone grafts, since the compounds can work in place of grafted tissue,” Dr. Plancher explains. “This eliminates the need for a second surgical site to harvest the graft, and also avoids possible problems with donated grafts or other tissues,” he concludes.
TOTAL SHOULDER ARTHROPLASTY involves replacement of the entire joint -- the ball, or humerus, and the socket, or glenoid -- with plastic and metal parts. These components are more resilient and durable than those made even a few years ago; many can last 15 years or more before requiring reconstruction. What’s more, they’re more “anatomic” – meaning that the replacement can replicate true human movement more closely – than ever before. No small feat, considering that the shoulder is the body’s most flexible joint, having more than 1,000 possible positions.
Until recently there were few studies to corroborate the success of shoulder replacement surgery. However, in a retrospective study presented at last year's AAOS annual meeting, nearly 75% of patients who had undergone Total Shoulder Arthroplasty between 10 and 20 years prior to the research rated the results as "excellent," and another 20% rated the results as "good."
As with any orthopedic surgery, Dr. Plancher urges patients to choose their surgeons carefully. A good place to start is the American Society of Shoulder and Elbow Surgery (www.ases-assn.org), an invitation-only medical organization for surgeons specializing in these areas. Dr. Plancher, a member of ASES, advises: "Particularly in areas like shoulder replacement, where there are few surgeons with a deep level of experience and expertise, patients need to be their own best advocates in choosing a doctor with whom they feel comfortable and trust.
"The news for tennis players and other 'overhead' sports enthusiasts couldn't be better," Dr. Plancher concludes. "The right shoulder surgery can restore a painless range of motion, allowing the baby boomer or weekend warrior to enjoy their favorite sport(s) again."
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