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Shoulder Joint Replacement with a "Swivel"

Surgical treatment for shoulder injuries improves every year. Doctors are looking for new ways to help patients with long-term shoulder pain. In this study, a special type of shoulder joint replacement was used for rotator cuff tears.

The rotator cuff is a group of four muscles and tendons that circle the shoulder. Treatment for a rotator cuff tear depends on the severity of the injury and may include physical therapy, cortisone injections, and several types of operations.

Rotator cuff tears may be partial or complete. Surgery is often needed when a complete or full tear of the rotator cuff occurs. If left untreated, the patient can end up with severe pain, loss of motion, and trouble doing daily activities. In severe cases, surgery may include a shoulder joint replacement called arthroplasty.

To put in a new joint, the surgeon takes off the end of the upper arm bone and replaces it with round ball on a stem. The stem is implanted into the arm bone. The ball fits into the shoulder socket. The old, damaged socket is removed and replaced with a plastic or titanium cup. When only one of these two parts is removed and replaced, it's called hemiarthroplasty.

This group of doctors tried a new method to treat problems from a full tear of the rotator cuff. They used a bipolar implant, which has a stem with a ball on the end that swivels. Bipolar implants have been used before for arthritis and fractures. Only two other studies have reported on its use with massive rotator cuff tears.

With this new type of implant, all of the patients were able to have pain-free sleep. Most patients also had pain-free use of their arm and rated their results as "excellent." The authors of this study believe that the bipolar method is a good option when treating this problem. Pain relief is more reliable than with standard hemiarthroplasty.

References: Ioannis K. Sarris, MD, PhD, et al. Bipolar Hemiarthroplasty for Chronic Rotator Cuff Tear Arthropathy. In The Journal of Arthroplasty. March 2003. Vol. 18. No. 2. Pp. 169-173.

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