Partial Shoulder Replacement Hospital in Ahmedabad

Partial shoulder replacement (shoulder hemiarthroplasty) is an operation in which only the ball of the shoulder joint - the upper end of the arm bone - is replaced with an artificial part, while the natural socket is kept. It is used when the damage is limited to the ball and the socket is still healthy.

Because a partial replacement keeps the natural socket, it is suitable only for selected patients. A careful assessment of the socket, the rotator cuff tendons and the bone decides whether a partial, total or reverse shoulder replacement is the right choice.

PMG Hospital (PMG Orthopedic Hospital), Gota, is an orthopedic hospital for partial shoulder replacement in Ahmedabad. This page explains when a partial replacement is used, the types of implant, the procedure, recovery, risks and cost factors.

What Is Partial Shoulder Replacement (Hemiarthroplasty)?

The shoulder is a ball-and-socket joint. In a partial shoulder replacement, the damaged ball (humeral head) is replaced with a smooth metal implant, while the socket (glenoid) on the shoulder blade is left in place. In a total shoulder replacement, by contrast, both the ball and the socket are replaced.

For a partial replacement to work well, the natural socket should have healthy cartilage, and the rotator cuff tendons should be working or able to heal.

Related pages: Shoulder replacement·Total shoulder replacement·Revision shoulder replacement

Stemmed Hemiarthroplasty and Humeral Head Resurfacing

Both types keep the natural socket. The surgeon advises which suits the shoulder after examination and scans.

When Is Partial Shoulder Replacement Used?

When the socket is also worn, a total shoulder replacement usually gives better pain relief. When the rotator cuff is badly torn and cannot be repaired, a reverse shoulder replacement is usually considered.

Signs That It May Be Time for an Assessment

• Shoulder pain that limits reaching, lifting, dressing or personal care
• Pain at rest or at night that disturbs sleep
• Stiffness or loss of movement
• Pain that continues despite medicines, injections and physiotherapy

Treatment Before Surgery

Except after a fracture that needs surgery, a replacement is usually advised only after other treatments have been tried, such as changes to daily activities, physiotherapy, pain-relief medicines used as advised by a doctor, and steroid injections in selected patients. In early avascular necrosis, other treatments may be possible before the ball collapses. A partial shoulder replacement treatment hospital should provide these non-surgical treatments as well as surgery. Tell the surgeon about any recent shoulder injection; a steroid injection within about three months before a replacement may increase the risk of infection.

Partial vs Total Shoulder Replacement

Assessment Before Surgery

A partial shoulder replacement doctor in Ahmedabad - an orthopaedic surgeon - assesses the shoulder before advising surgery:

1. 1History and examination: pain, movement, strength of the rotator cuff, nerve and blood supply of the arm (especially after an injury), and the neck
2. 2X-rays of the shoulder: to see the ball, the socket and any fracture
3. 3CT scan: in selected cases, to assess the socket, the bone and the pattern of a fracture
4. 4MRI: in selected cases, to assess avascular necrosis, the cartilage of the socket and the rotator cuff
5. 5Fitness for surgery: blood tests, ECG, blood sugar and blood pressure control, and checks of the heart, lungs and kidneys as needed
6. 6Infection check and medicines: any infection is treated before surgery, and blood thinners and some other medicines may need to be stopped or changed, only as advised by the doctor

Partial Shoulder Replacement Surgery in Ahmedabad: Step by Step

The main steps are similar in any partial shoulder replacement surgery hospital in Ahmedabad:

1. 1Anaesthesia: usually general anaesthesia, often with a nerve block in the neck that numbs the shoulder and arm for pain relief after surgery
2. 2Approach: the joint is reached through a cut over the front of the shoulder, usually by detaching the subscapularis tendon (a rotator cuff tendon at the front), which is repaired at the end
3. 3Preparing the ball: the damaged ball is removed and the arm bone is prepared for a stem, or the ball is reshaped for a resurfacing cap
4. 4Checking the socket: the natural socket is inspected and left in place
5. 5Fitting the implant: the stemmed implant is fixed with or without bone cement, or the resurfacing cap is fitted; after a fracture, the pieces of bone that carry the rotator cuff tendons are fixed around the implant with strong sutures
6. 6Closure: the tendons and skin are closed and dressed, and the arm is placed in a sling; the operation usually takes about one and a half to two hours

Recovery After Partial Shoulder Replacement

This is a general guide. After surgery for a fracture, recovery is usually slower, because the fixed pieces of bone and the tendons attached to them must heal before the shoulder is exercised more actively.

Care After Surgery

• Wear the sling as advised, including at night in the early weeks
• Until the surgeon allows it, do not lift heavy objects, push yourself up from a chair or bed with the operated arm, or force the arm outward or behind your back
• Do the exercises taught by the physiotherapist every day; they are a key part of recovery
• Keep the wound clean and dry until it has healed
• Attend follow-up visits, including X-rays as advised

How Long Does a Partial Shoulder Replacement Last?

A large study of published case series and a national joint registry found that most partial shoulder replacements (roughly eight to nine in ten) had not needed revision surgery 10 years after the operation, a slightly lower proportion than for total shoulder replacements. Information on longer periods is limited. The main long-term problem is wear of the natural socket (glenoid erosion), which can cause pain. If this happens, the partial replacement can usually be converted to a total or reverse shoulder replacement in a further operation, although results after conversion are generally not as good as when a total or reverse replacement is the first operation.

Source: Evans JP et al. The Lancet Rheumatology. 2020;2:e539–e548.

Risks and Possible Complications

Partial shoulder replacement is a common operation, but no surgery is without risk. The surgeon explains these risks before taking consent.

• Infection of the wound or around the implant, which may need further surgery; infection can appear months or years later, sometimes only as increasing pain or stiffness without fever
• Instability or dislocation of the new joint
• Injury to nerves (such as the axillary nerve) or blood vessels, which is uncommon; nerve problems are often temporary
• Fracture of the arm bone or shoulder blade during or after surgery
• Stiffness or limited movement, especially when exercises cannot be continued
• Loosening or wear of the implant over time, which may need revision surgery
• Blood clots in the arm or leg veins or lungs, which are less common than after hip or knee replacement
• Continuing pain or weakness in some patients
• Anaesthesia-related and general medical risks, including temporary numbness of the arm after a nerve block; the nerve block in the neck can also weaken the breathing muscle on that side for some hours, so tell the anaesthetist if you have lung disease; and heart, lung or kidney problems, especially in older patients or those with other illnesses
• Wear of the natural socket over time, causing pain, which may need conversion to a total or reverse replacement
• Failure of the fractured pieces of bone to heal in the correct position after surgery for a fracture, which can cause weakness and limited lifting of the arm

Partial Shoulder Replacement Surgery Hospital in Ahmedabad

When choosing a partial shoulder replacement hospital in Ahmedabad, check that the treating surgeon is a qualified orthopaedic surgeon with valid medical council registration, that the hospital regularly performs this operation, how infection is prevented, which implants and tests are available, what physiotherapy and follow-up are provided, and what the written estimate includes.

Partial Shoulder Replacement Surgery Cost in Ahmedabad

• The implant chosen (stemmed or resurfacing)
• Whether the surgery is for a fracture
• Length of hospital stay and room category
• Other medical conditions and any extra care needed
• Physiotherapy and follow-up

A written, itemised estimate can be requested from the hospital after assessment.

Insurance

• Medically necessary shoulder replacement is generally covered under health insurance policies, subject to policy terms, waiting periods and insurer approval
• Some policies have limits on room rent or implant costs; check these with your insurer before surgery
• Ask the hospital whether cashless treatment is available with your insurer, and which documents are needed

Partial Shoulder Replacement Doctor in Ahmedabad

Partial shoulder replacement is planned and performed by an orthopaedic surgeon who works in shoulder or joint replacement. A family physician or, after a fall, an emergency doctor may see you first and refer you, but the choice between a partial, total or reverse replacement is made by the orthopaedic surgeon. Different doctors and team members are involved at different stages:

Partial Shoulder Replacement Surgery Doctor in Ahmedabad

Before agreeing to the operation, it is reasonable to ask your partial shoulder replacement surgery doctor in Ahmedabad a few clear questions. The answers help you understand the plan and give informed consent.

Treating Surgeon

At PMG Hospital, partial shoulder replacement is performed by:

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Facilities at PMG Hospital

• Orthopaedic OPD, Monday to Saturday
• Emergency and trauma care, 24×7
• Orthopaedic physiotherapy centre

Frequently Asked Questions

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