Glenohumeral Joint Surgery And Postoperative Management

By Carolyn Kisner PT, MS and Lynn Allen Colby PT, MS on November 26th 2008

Severe deterioration of one or both surfaces of the GH joint, causing significant pain and loss of upper extremity function, or an acute or nonunion fracture of the proximal humerus often must be addressed with surgical intervention. Underlying pathologies, causing advanced joint destruction, include late-stage osteoarthritis (OA), rheumatoid arthritis (RA), traumatic arthritis, cuff tear arthropathy, and osteonecrosis (avascular necrosis) of the head of the humerus as the result of a fracture of the anatomical neck of the humerus or long-term use of steroids for systemic disease.

The most common surgical procedure used to treat advanced shoulder joint pathology is glenohumeral arthroplasty, often simply referred to as shoulder arthroplasty. In rare situations, arthrodesis (surgical ankylosis) of the GH joint may have to be selected as an alternative to arthroplasty or as a salvage procedure.

The goals of these surgical procedures and postoperative rehabilitation are to (1) relieve pain, (2) improve shoulder mobility or stability, and (3) restore or improve strength and functional use of the upper extremity. The extent to which these goals are achieved is predicated on the patient’s participation in postoperative rehabilitation, the distinguishing features and severity of the underlying pathology, the prosthetic design and surgical techniques, the integrity of the rotator cuff mechanism and other soft tissues, and the age, overall health, and anticipated activity level of the patient.

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Filed Under: Physical Therapy, cheng
Tags: arthrodesis, arthropathy, arthroplasty, extremity, osteonecrosis, prosthetic

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