Arthritis in the shoulder is somewhat uncommon, with about 40,000 shoulder replacements being performed each year in the United States. By comparison, 450,000 knee and 230,000 hip replacements are performed annually. But the increasing reports of shoulder arthritis in young patients is alarming on many levels.

For starters, current shoulder replacement techniques do not adequately address the high function demands of young active patients. And while shoulder replacement may help relieve pain, many of these young patients who have shoulder replacement surgery will require further shoulder reconstructive surgery in the future.

The arthritic condition many of these young people suffer with is known as chondrolysis, a condition in which the cartilage in the shoulder joint wears away causing bone to rub against bone. There is no cure, and those who have chondrolysis often suffer from pain, limited mobility and debilitation. In many cases patients require shoulder replacement surgery.

As more and more reports of chondrolysis were being reported in patients following shoulder surgery, surgeons and researchers began to ask why. Laboratory data and clinical reports began pointing to the same likely culprit – the prolonged use of intra-articular local anesthetics administered directly into the shoulder joint by a pain pump device. Investigations found that this was not an FDA-approved use for the pain pump or the anesthetic; however, that didn’t stop pain pump manufacturers from instructing surgeons to use the device in such a way.

Surgeons are now understanding how they have been misled by the makers of pain pumps and with luck, the number of new chondrolysis reports will decrease in time. Until then, the only recourse victims have is to go after the pain pump manufacturers in court.

Source: Gerson Lehrman Group

SOURCE: Pain Pumps › Reports of young patients with arthritis in shoulder increasing

But Smith’s doctor, Bryan Wall, an orthopedic surgeon at the Core Institute of Phoenix, Ariz., wasn’t giving up. He suggested Smith have a new procedure, a reverse shoulder replacement. Approved by the Food and Drug Administration (FDA) in 2004, the procedure offers relief to some patients who suffer long-term rotator cuff tears with arthritis. During the procedure, surgeons place an implant in the shoulder that is designed so that the ball portion of the shoulder is attached directly to the shoulder blade. The socket is then placed at the upper end of the arm bone. The procedure essentially reverses the anatomy of the shoulder.

“What it does is it allows us to not only replace the joint that has become arthritic, but it puts the shoulder in a better mechanical position and changes the mechanics of the shoulder to allow people to elevate their arm,” Dr. Wall explained.

The result was life-changing for Smith, who said he no longer has pain in his right arm and is able to get on with an active retirement. However, Dr. Wall warns, the procedure is not recommended for all patients. The best recipients are older patients who are less likely to put extreme stress on the shoulder joint.

SOURCE: Pain Pumps › New procedure may prove effective for some shoulder injuries