Total Shoulder Replacement

Question 1

What is a Total Shoulder Arthroplasty?

Answer 1

Replacement of the Humeral Head and Glenoid Fossa

Question 2

What are the two most common causes of a Total Shoulder Arthroplasty?

Answer 2

• Arthritis (1st)

- Fractures (2nd)

Question 3

Where is the skin incision made during a Total Shoulder Arthroplasty- Anterior Approach?

Answer 3

Deltopectoral line

Question 4

What do you need to be careful of when making the Deltopectoral incision?

Answer 4

Not to cut the Cephalic Vein

Question 5

What occurs after making the Deltopectoral incision?

Answer 5

• Subscapularis tendon tagged with 0 Ethibond
• Subscapularis tendon dissected off of Humeral head
• Humeral head osteotomy performed
  
  • Shaving off of Humeral head

Question 6

What occurs after the Glenoid Fossa is exposed?

Answer 6

• Labrum and capsule is removed from Glenoid
• Central pilot hole is drilled for reaming of Glenoid
• Multiple holes drilled for prosthesis to fit in Glenoid
• Trial prosthesis used to measure fit
• Permanent prosthesis placed

Question 7

What occurs after the Glenoid is replaced?

Answer 7

• Humeral shaft is cleaned out to remove cartilage
• Trial Humeral Head and Stem inserted to check size
• Shoulder is reduced and range of motion is tested
• Permanent prosthesis inserted

Question 8

What are the steps for closure after a Total Shoulder Arthroplasty?

Answer 8

• Subscapularis reattached using 0 Ethibond suture
• Fascia closed
• Dermis closed
• Skin closed

Question 9

What type of suture is used to close the Fascia in a Total Shoulder Replacement?

Answer 9

2-0 Vicryl on a CT1 needle

-Interrupted Deep Buried

Question 10

What type of suture is used to close the Dermis in a Total Shoulder Replacement?

Answer 10

3-0 Vicryl on a CT1 needle

-Interrupted Deep Buried

Question 11

What type of suture is used to close the Skin in a Total Shoulder Replacement?

Answer 11

4-0 Monocryl on a PS2 needle

-Intracuticular

Question 12

What are the dressings for a Total Shoulder Arthroplasty?

Answer 12

• Steristrips
• 4x4s
• ABDs
• Medipore tape

Question 13

What equipment is sent home with the patient after a Total Shoulder Arthroplasty?

Answer 13

• Immobilizer sling
• Duracold
  
  • Strapped to the shoulder

Question 14

What is different about a Reverse Total Shoulder?

Answer 14

The “ball” component goes in the Glenoid Fossa and the “cup” component goes on the Humeral head

Question 15

When is a Reverse Total Shoulder performed?

Answer 15

When a patient has a severe Rotator Cuff tear

-Rotator Cuff muscles are need to hold Humerus into the Glenoid Fossa because it is not a “true” ball and socket joint