Simpliciti Canal-Sparing Total Shoulder Arthroplasty
When the shoulder joint is affected by arthritis, the cartilage lining the articulating bones breaks down. This causes the bones to rub against each other leading to pain and inflammation.
Advanced arthritis can make it difficult for you to move or lift your arm and carry out various activities. The pain can even interfere with sleep.
To treat advanced arthritis your doctor may recommend a total shoulder arthroplasty, also called a total shoulder replacement.
The shoulder is a ball-and-socket joint. The ball is formed by the end of the upper arm bone and the socket is formed by the shoulder blade. In a total joint replacement, both the ball and the socket portions of the joint are replaced by implants to create a new joint. While replacing the ball, traditional shoulder arthroplasty uses an implant with a stem that inserts into the canal of the upper arm bone. This can involve a lot of bone removal increasing the risk of a fracture. Another disadvantage is that such an implant is difficult to replace should a repeat procedure be needed in the future.
Simpliciti is a canal-sparing shoulder replacement system that does not use a stem implant. Instead, its nucleus design secures the implant in place with minimal loss of bone structure
Indications of Simpliciti Canal-Sparing Total Shoulder Arthroplasty
Simpliciti may be recommended if you have arthritis due to overuse, age or trauma that is causing disabling pain in your shoulder and non-surgical treatments have not provided adequate relief.
Before the procedure, your doctor will perform an examination and ensure that you have a healthy bone to support the implant and no problems with your rotator cuff, the group of muscles that stabilize the shoulder joint.
Surgical Procedure of Simpliciti Canal-Sparing Total Shoulder Arthroplasty
For the operation, you will be placed in a supine position. The shoulder joint is accessed through an incision between the shoulder and chest muscles. The joint is dislocated and the humeral head brought forward. Any bony overgrowths present are removed from the humeral head.
A guide is used to determine the humeral inclination and the humeral head is appropriately resected. A sizer is placed over the resected surface to help determine the appropriate humeral implant size. A guide pin is placed through the central hole of the sizer. It is precisely oriented and engages the bone. The sizer is then removed and the resected surface is planed flat. With the help of the guide pin, the bone is drilled and a component impacted into the bone to receive a trial head implant. The guide pin is then removed and the humeral surface protected while the glenoid surface is prepared.
The trial humeral head implant is then sized and fixed to the impacted component. Once in place, the shoulder joint is reduced and tested to determine if the size is appropriate and does not interfere with movement. The shoulder joint is then dislocated again. The trial implant and component are removed. An appropriate size nucleus implant is impacted into the bone and the final humeral head implant is fixed to it. Soft tissue repairs are then performed and the incision is closed. Your arm is then placed in a sling.
Postoperative Care for Simpliciti Canal-Sparing Total Shoulder Arthroplasty
The sling is removed the next day and the shoulder joint is mobilized. Certain movements and activities are restricted for a while during the healing process. The use of the arm is encouraged though for routine activities. You will begin shoulder strengthening exercises about eight weeks after the procedure and will gradually be able to tolerate more strenuous activities.
Advantages of Simpliciti Canal-Sparing Total Shoulder Arthroplasty
Using the Simpliciti shoulder replacement system has the following advantages over traditional surgery:
- Placement of the implant is easier
- Operating time is reduced
- Less blood loss
- Less pain after surgery with a faster recovery
- More bone is preserved making it easier to repeat the procedure in the future.