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Shoulder Fusion: When and How It's Used
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Posted on: 04/13/2006
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In this article doctors from the Cleveland Clinic in Ohio review fusion of the shoulder joint called arthrodesis. With total shoulder replacements available today, the need for shoulder arthrodesis is much less. But there are still times when fusion is the only answer.
The most common use of shoulder fusion is after severe shoulder injury from car accidents. Nerve damage or massive rotator cuff tears may leave the shoulder with severe loss of motion and function.
Tumors that destroy tissue and bone is another problem that can lead to shoulder arthrodesis. Once the tumor and surrounding tissue have been removed, then the surgeon decides if shoulder replacement or shoulder fusion is best.
Sometimes shoulder arthrodesis is needed after a total shoulder replacement (TSR). The TSR that fails for any reason may have to be removed. Loss of bone and muscle control may require a fusion to regain shoulder stability.
The authors show how they used metal plating and screws to hold the shoulder in place. Some motion is still possible. The patient must be able to lift the arm to shoulder height and touch the top of the head. Available motion also allows the patient to reach into the back pocket on the same side as the fusion.
Shoulder arthrodesis should not be used for patients with severe problems in both shoulders. Fusion in both shoulders wouldn't allow them to do their daily activities of self-care. Older adults with neurologic problems are also not good candidates for this operation. Results are often unsatisfactory.
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References:
Ori Safran, MD, and Joseph P. Iannotti, MD, PhD. Arthrodesis of the Shoulder. In Journal of the American Academy of Orthopaedic Surgeons. March 2006. Vol. 14. No. 3. Pp. 145-153.
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