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Unique Shoulder Replacement Operation in India Restores American's Mobility
Metal & stem cells resurfacing restored an American builder's mobility in India
Discussion- Shoulder arthritis is an increasing problem in the aging population. Risk factors include certain occupations involving heavy activity.
Mild cases can be treated with physical therapy and over-the-counter medications. More advanced cases unresponsive to conservative treatment can be managed with stem cell injections. Surgery is required in severe cases. Surgical options include arthroscopic debridement, hemiarthroplasty or total shoulder replacement.
Shoulder resurfacing is a bone wall preserving alternative to shoulder replacement. In this operation the ball of the shoulder joint is not sacrificed but does only s craped to receive a metal cap.
The socket can be left alone or if severely arthritic, can be replaced with a plastic component. Failure of a shoulder replacement usually results from wear particles of the plastic component. This may need a revision shoulder replacement. In order to minimise revision surgery, surgeons often only do a hemiarthroplasty by addressing only the ball component of the shoulder joint and don't replace the socket. Instead, surgeons perforate the articular surface of the socket and by a procedure known as micro-fracture. This works by leakage of bone marrow containing stem cells into the area. The clot sets and later forms a layer of fibro cartilage. Other surgeons have performed a biological resurfacing of the socket by suturing a piece of piece of fascia over the damaged socket. The success of stem cell repair of cartilage defects in the knee encouraged me to address the arthritic socket by the same method. A glue comprising of stem cells and clotting factors was applied after micro-fracture of the socket. This glue set and formed a new lining over the damaged socket. The ball of the shoulder joint was resurfaced with a metal component.
The patient recovered pain-free mobility rapidly.
This is the first time in which stem cells were was used to resurface the socket of the shoulder joint. The procedure was performed by an open method. Smaller areas of cartilage loss can be treated by the same method with key hole surgery. Biological treatment methods are making inroads in to traditional orthopaedic surgery which involves joint replacements.