Reverse shoulder replacement procedure at LLUMC offers patients relief
Wesley Phipatanakul, MD, a fellowship-trained shoulder surgeon and assistant professor of orthopaedic surgery at Loma Linda University, has been helping patients needing shoulder surgery find relief with a reverse shoulder replacement procedure since the FDA approved it in 2004. The procedure is indicated for patients who have pain and limited motion due to shoulder arthritis and a torn rotator cuff. The rotator cuff is a group of muscles that function to stabilize the shoulder and move the arm. Conventional shoulder replacements must have a functional rotator cuff to be successful. A “reverse” design works because it allows other muscles to substitute for the function of the rotator cuff to move the arm.
“This replacement now gives us a treatment option for what was previously an untreatable problem,” says Dr. Phipatanakul.
Martha Counts, a 77-year-old Yucca Valley resident, fell eight years ago when she lived alone in Fresno. A traditional shoulder replacement failed to improve her pain or her range of motion. But since the reverse surgery, she says she has not had an any trouble with her shoulder.
“I followed the recommended therapy for six weeks. Before, I couldn’t mop, hang my clothes up, I pretty much couldn’t do anything with my right arm,” recalls Ms. Counts. “Now I can do things for myself without having to ask someone to do it for me.”
Saralyn Patrick, from Murrieta, will turn 71 in November. Three years ago she tore her rotator cuff. She had the reverse procedure in 2004 and says, “There’s not a whole lot I don’t do now.
“I went and had the surgery done on a Thursday and went home Friday afternoon,” says Ms. Patrick. “I took one Vicodin, and then all I needed was aspirin and ibuprofen and that would take care of the pain. I was up by Monday following surgery. I wasn’t running, but I was able to get to the table to eat and go to the bathroom without any assistance.”
Dr. Phipatanakul was able to help these two ladies and more because of the way the prosthesis is implanted. The shoulder joint consists of two bones, the arm bone and the shoulder socket. The top of the arm bone that faces the socket is shaped like a scoop of ice cream on a cone. In a standard replacement a circular metal component is placed on top of the arm bone to replicate the usual anatomy. In a reverse replacement a round sphere is fixed to the shoulder socket with metal screws instead of on the arm bone, which gives the procedure its “reverse” title.
To find out more about this innovative procedure, you can reach Dr. Phipatanakul at (909) 558-2039, or the Orthopaedic Surgery Clinic at Loma Linda University Medical Center can be reached at (909) 558-2808.
By Preston Clarke Smith