Virtual shoulder replacement game

Hoenecke has focused on shoulder replacement surgeries since and now performs more than 80 such procedures a year. Hoenecke said. Following successful surgery, Barnard pushed through an aggressive regimen of strengthening and range-of-motion exercises with physical therapist Diane Fons.

He was pleasantly surprised when was able to serve a tennis ball just six months after surgery. Barnard, a former San Diego Police Department detective, gives back as a board member of the Escondido Creek Conservancy, which has helped preserve thousands of acres of natural open space.

Barnard, Fons and Dr. However, arthroscopic surgery primarily treats conditions that cause arthritis, rather than the arthritis itself. This treatment is generally useful in patients who do not yet have bone-on-bone arthritis.

In traditional shoulder replacement surgery, the damaged humeral head the ball of the joint is replaced with a metal ball, and the glenoid cavity the joint socket is replaced with a smooth plastic cup. The humeral head is at the top of the humerus — the upper arm bone, and the glenoid is located in the scapula — the shoulder blade.

This metal-on-plastic implant system rather than metal-on-metal is used in virtually all shoulder replacement. In some patients, such as those with severe shoulder fractures of the humeral head, a partial shoulder replacement called hemireplacement may be recommended. This technique replaces the ball component only. During a total shoulder replacement, the patient may have either regional anesthesia with interscalene block or general anesthesia — or both. During the operation, the patient will be positioned sitting upright and partially or completely sedated.

A traditional anatomic shoulder replacement surgery is composed of the following six basic steps:. In recent years, a newer type of surgery, called "reverse shoulder replacement" was introduced see Figure 6. A reverse shoulder replacement is a design in which the positions of the ball and socket are switched: A metal ball implant is placed where the patient's own natural socket was, and a plastic socket implant is placed on the head of the humeral head.

This reverse design has more stability and does not need the tendons to hold it in place. It's motion is controlled by the deltoid muscle rather than the rotator cuff tendon. This make it an ideal choice when the damaged shoulder needs new surfaces, but does not have sufficiently healthy soft tissues to support stabilization and movement.

It is commonly performed on patients who have shoulder arthritis and a severer rotator cuff tear. The design rationale for the reverse shoulder replacement is as follows: In a healthy person, the shoulder ball rests against the socket rather than being deeply contained within the socket, as in a hip joint.

Because of this position, the ball relies on the tendons that surround the it and socket to both hold it in place and to move it. But with some types of arthritis, these tendons are severely damaged, torn or nonfunctioning.

Find a surgeon at HSS who performs reverse total shoulder replacement. All shoulder replacement systems share the same basic components: a metal ball that rests against a plastic polyethylene socket. But their designs vary. The polyethylene socket in a traditional shoulder replacement is often cemented to the bone surrounding it, at least in part, so that fixation to the bone is immediate. The prosthetic ball has a stem that is usually placed inside the humerus without the need for cement.

In most cases, the design of the stem prosthesis promotes, osseointegration, in which the patient's natural bone grows into the prosthetic material. Surgeons from Hospital for Special Surgery designed a special implant called the Comprehensive Primary Shoulder System see Figure 4 , with a cobalt-chrome or titanium ball and a titanium stem.

The ball, stem and socket all fit together in ways that provide a more customized fit. Find a surgeon at HSS who performs anatomic total shoulder replacement. The components are still metal and plastic, but reversed: The metal ball is attached to the patient's existing socket, and a new plastic socket is attached to the patient's upper humerus, which formerly included the natural ball of the anatomic shoulder.

The stem is designed to be cementless to promote the ingrowth of bone into the prosthesis. This allows people to achieve normal or near normal motion and consequently the ability to return to sports like golf, tennis and swimming. In my practice, I allow my patients to return to golf progressively. Putting is allowed at 2 months after surgery. At 3 to 4 months chipping is allowed and at 4 to 6 months a full swing is allowed. I have also noted that patients with a shoulder replacement often report playing at a better level than prior to surgery!