Here are some answers to common questions about the procedure.

When do you potentially need a shoulder replacement?

• When your shoulder consistently gives you pain
• When movement has become too restrictive
• When it no longer responds to such treatments as physical therapy and medications, including pain-relieving injections

What are the causes of these shoulder conditions?

• Osteoarthritis
• Rheumatoid Arthritis
• Posttraumatic Arthritis
• Rotator Cuff Tear Arthropathy
• Avascular Necrosis
• Severe Injury

Who is a likely candidate for the surgery?

• General good health
• Appropriate weight (BMI <40)
• Non-smoker
• Arthritis that has failed to respond to conservative treatment

How common is shoulder surgery?

Shoulder joint replacement has become increasingly common, and is now as effective as knee and hip replacement surgery to help patients get back to their normal activities without pain. According to the Journal of Shoulder and Elbow Surgery, 175,000 to 350,000 procedures per year may be performed by 2025. Orthopedic Performance Institute surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, routinely perform shoulder replacement surgery.

How is it done?

Total shoulder replacement surgery, also known as shoulder arthroplasty, involves removing the damaged portions of the shoulder joint and replacing them with artificial components, collectively referred to as a prosthesis.

The surgeon begins by making an incision over the shoulder to access the joint. The damaged or arthritic cartilage and bone from the head of the humerus (the upper arm bone) and sometimes the socket of the scapula (the glenoid) are carefully removed. These surfaces are then reshaped to fit the prosthetic components.

The artificial joint is made from metal and plastic materials designed to mimic the natural anatomy and function of the shoulder. Cement or a press-fit technique may be used to secure the prosthesis, depending on bone quality and the specific implant design.

Replacement Options

There are different types of shoulder replacement procedures, depending on the extent of joint damage and the patient’s needs:

• Partial Shoulder Replacement (Hemiarthroplasty)
  In this procedure, only the head of the humerus (the “ball” of the joint) is replaced with a metal implant. The socket (glenoid) is left intact. This option is often chosen when the glenoid is healthy or when the damage is primarily limited to the humeral head, such as in some fractures.
• Total Shoulder Replacement (Anatomic Total Shoulder Arthroplasty)
  Both the ball (humeral head) and the socket (glenoid) are replaced. The humeral component is typically metal, while the glenoid component is made of medical-grade plastic (polyethylene). This is the most common type of shoulder replacement and is generally recommended for patients with osteoarthritis, rheumatoid arthritis, or severe joint damage.
• Reverse Shoulder Replacement (Reverse Total Shoulder Arthroplasty)
  In cases where the rotator cuff is severely damaged or nonfunctional, a reverse shoulder replacement may be used. This procedure reverses the normal ball-and-socket configuration: a metal ball is attached to the scapula, and a plastic socket is placed on the top of the humerus. This design relies on the deltoid muscle rather than the rotator cuff to lift the arm, making it ideal for patients with rotator cuff arthropathy.

Your orthopedic surgeon will determine which course of action to take.

What evaluation processes are involved?

The Orthopedic Performance Institute’s Dr. Matthew Dwyer and Dr. Christopher Phelps will evaluate you in four key areas.

1. Medical history. You’ll be asked about your overall health, pain and ability to perform everyday activities.
2. Physical examination. This will assess your shoulder motion ad strength.
3. X-rays. These will allow the doctors to evaluate the damage and what needs to be replaced.
4. CT scans and MRIs. These procedures may be warranted to allow a closer examination of the bone and soft tissue.

How long is the surgery?

The procedure is typically performed under general anesthesia and may take about 1.5 to 3 hours, depending on the complexity. Afterwards, you will either be released home or be admitted to the hospital for further observation.

What is the recovery timetable?

Recovery from shoulder surgery is a gradual process that typically spans about a year. In the first 1–2 weeks, patients begin gentle home physical therapy focused on passive range of motion, while keeping the shoulder dry until the surgical dressing is removed during the two-week follow-up. Sling immobilization is crucial during the first six weeks. From weeks 2–6, outpatient physical therapy continues to focus on passive motion, still with sling use. Between weeks 6–10, patients can discontinue the sling and begin active range of motion exercises, avoiding any lifting. From weeks 10–14, therapy progresses to include strengthening exercises. By 3–6 months, most patients follow a home regimen to further improve motion and build strength. Full recovery is typically achieved around one year post-surgery.

Contact Us Today

Don’t let shoulder pain keep you from the activities you love. Contact the Orthopedic Performance Institute in San Antonio at (210) 545-7171 for a complete evaluation with Dr. Christopher Phelps or Dr. Matthew Dwyer.

The post Total Shoulder Replacement Surgery: Benefits, Risks, and What to Expect appeared first on Orthopedic Performance.

• Hip or groin pain that limits your daily activities
• Hip pain that makes it hard to get in and out of chairs
• Hip pain that keeps you awake at night
• Hip pain that doesn’t improve with other treatments, like injections, braces, or exercises

Any of these conditions may call for surgery, and the Orthopedic Performance Institute practices two techniques:

Posterior Hip Replacement

With this technique, the surgeon makes incisions in the back of the hip. Muscles and ligaments are separated to gain access to the hip bone. Dating back to the 1950s and even before, it is the traditional and most common method for hip replacement.

It may be the only option for these patients:

• Patients who are obese
• Patients who have certain medical conditions such as severe arthritis
• Patients who have had previous hip surgeries

Anterior Hip Replacement

The Orthopedic Performance Institute offers the anterior technique that can offer benefits not available with traditional hip replacement surgery. Since this surgery is more technically demanding, OPI is one of the area’s leading practitioners of the technique.

With anterior surgery, the surgeon approaches the hip bone from the front. It is known as “muscle-sparing” surgery because it does not require cutting of muscles. Because there is less muscle trauma, patients experience less postoperative pain and a faster recover time.

To qualify for the anterior hip replacement surgery, candidates must:

• Be in generally good health
• Maintain an average weight with less muscle mass and fat in the thigh area
• Be mobile, active and independent before surgery
• Have a good support system at home

The anterior hip replacement technique has fewer restrictions on mobility and activities than traditional hip surgery. Patients can immediately use their hip, allowing it to bear their total weight (as long as it’s not uncomfortable) and are allowed to bend it freely. This results in a faster resumption of their normal daily activities.

Recent advancements in surgical technique, instrumentation and patient selection have made anterior hip replacement a preferred option for qualifying patients who require total hip replacement. If performed by an experienced surgeon on the properly selected patient, an anterior hip replacement can result in a rapid recovery during the weeks after surgery.

Dr. Christopher Phelps

“I like to perform the anterior technique on hip replacement patients when possible because the patient experience is dramatically better. They recover quicker and have less pain,” says orthopedic surgeon, Dr. Christopher Phelps.

Don’t let hip pain take you away from your active lifestyle. Contact the Orthopedic Performance Institute in San Antonio to consult with the experts!

The post Anterior and Posterior Hip Replacements: A Comparison appeared first on Orthopedic Performance.

Orthopedic surgery can be applied in situations where non-surgical treatments have failed to provide relief from pain or address the underlying condition.

While every patient’s situation is unique, there are some common reasons that orthopedic surgery may be called for:

Severe Trauma or Injury

In cases of severe trauma or injury to the musculoskeletal system, orthopedic surgery may be necessary. These conditions include:

• Fractures that cannot be effectively treated with casting or immobilization alone
• Dislocations
• Severe ligament or tendon tears
• Complex joint injurie

Surgery is performed to realign bones, repair damaged tissues and restore stability and function.

Chronic Pain and Degenerative Conditions

Chronic pain that is caused by degenerative conditions like osteoarthritis, rheumatoid arthritis or spinal disc herniation may require orthopedic surgery after the gauntlet of non-surgical options have been exhausted.

Joint replacement surgeries such as hip or knee replacements can provide significant pain relief and improve mobility for individuals with severe joint damage.

Sports Injuries

Athletes who sustain sports injuries such as torn ligaments (ACL, MCL), meniscus tears or cartilage damage can benefit from orthopedic surgery. Depending on the severity and location of the injury, arthroscopic procedures or reconstructive surgeries may be utilized.

These surgeries intend to restore function, stability and range of motion, allowing athletes to get back in the game.

Congenital or Developmental Abnormalities

Orthopedic surgery may be in order for individuals who suffer from congenital or developmental abnormalities of the musculoskeletal system. These conditions can include scoliosis, hip dysplasia, or limb length discrepancies. Orthopedic surgery can:

• Correct deformities
• Improve function
• Prevent long-term complications

Such surgeries are typically performed on children or adolescents to optimize healthy growth and development.

Infection or Tumor

Orthopedic surgery may be necessary to treat infections or tumors that affect the musculoskeletal system.

Surgeries such as debridement (removal of infected tissues), bone grafting or tumor excision are ways to eliminate infections or remove cancerous or benign tumors. These procedures are essential for:

• Preventing the continuing spread of infection
• Preserving limb function
• Avoiding further potential malignancies

Considerations for Undergoing Surgery

The decision to undergo orthopedic surgery is made on a case-by-case basis, taking into consideration such factors such as the patient’s overall health, lifestyle, and goals.

Orthopedic surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, at the Orthopedic Performance Institute will work closely with you to assess your condition, explore more conservative treatment options, and determine whether surgery is the most appropriate course of action.

Contact the Orthopedic Performance Institute in San Antonio or Boerne at (210) 545-7171 for more information or to schedule an examination.

The post When do you need orthopedic surgery? appeared first on Orthopedic Performance.

Dr. Christopher Phelps is now scheduling outpatient procedures in the Bulverde/Spring Branch area at the Singing Hills-Legent Orthopedic & Spine Center. The center is located at 524 Singing Oaks, Spring Branch, 78070.

PROCEDURES

Outpatient procedures performed include arthroscopy and total shoulder, knee, and hip replacements. Patients are evaluated to ensure they’re eligible for an outpatient joint replacement procedure.

INSURANCE

We accept most health insurance plans and will work with you every step of the way to confirm benefits and file claims.

TO SCHEDULE

Call (210) 545-7171 to schedule with a member of our friendly staff.

The post Outpatient Procedures Now Offered in Bulverde appeared first on Orthopedic Performance.