Partial Shoulder Reconstruction Option for More Patients and Ideal for Outpatient Surgery

Advances in Joint Implants Benefiting Shoulder Repairs.

Advances in repair of the shoulder’s ball-and-socket joint are making partial joint replacement rather than total joint replacement a more viable option for a growing number of patients, especially those who are more active and athletic, according to noted hand and upper limb orthopedic surgeon Alejandro Badia MD, founder and chief medical officer of the Florida-based Badia Hand to Shoulder Center and OrthoNOW®. Moreover, this type of joint replacement is ideal for the growing movement towards outpatient surgery. Read also: More Joint Reconstruction Moving to Outpatient Setting

Partial shoulder joint replacement, particularly with a stemless implant is less invasive than total joint replacement, preserves natural bone, allows quicker recovery, and, thanks to new technologies is becoming an increasingly successful, long-term solution for disorders that cause shoulder pain and loss of function,” Dr. Badia says.

One of those “new technologies” is the Catalyst CSR™ Total Shoulder System, featuring a stemless, non-spherical implant and patented instrumentation that can be used for partial or total joint replacements for patients of all ages. The implant’s accuracy has been found to better recreate a shoulder’s natural center of rotation, which could minimize risk of failed joint repairs caused by misaligned shoulder implants.

“Until now, total joint replacement has been the gold standard for treating shoulder-joint problems that have not responded to conservative therapies. But, during the past several years, we have seen emergence of revolutionary technologies like the Catalyst CSR system. These advanced tools allow us as surgeons to restore the biomechanics of the shoulder with minimally invasive, bone-sparing approaches on an outpatient basis,” says Dr. Badia.

“In fact, mounting research evidence suggests that partial shoulder replacement, where only the “ball” part of the ball-and-socket joint is replaced, may be a preferred alternative for maintaining shoulder-joint viability in more active and athletic patients. As these patients maintain their activity and their joint implants wear, they may require future joint surgery, which will be much more easily and successfully performed because their earlier procedure with an implant like the Catalyst CSR has left more of their natural bone intact,” says Dr. Badia.

Injury, osteoarthritis, post-trauma arthritis and avascular necrosis (reduced blood flow to the shoulder causing deterioration of bone) are all disorders that can compromise shoulder-joint cartilage. It is this cartilage that creates the smooth surface on which the ball at the top of the forearm – the humerus — can glide readily within the shoulder blade socket, or glenoid. Loss of this cartilage leads to shoulder pain, swelling, stiffness and decreased range of motion.

Total joint replacement requires cutting away bone to accommodate an implant with a stem that anchors it at the top of the humerus and replacing scapula bone with a prosthesis. In a partial joint replacement procedure with a stemless implant, the surgeon simply clears the diseased area from the ball of the humerus and then caps it with a metallic (cobalt chromium) component that fits into the glenoid socket, restoring the normal anatomy of the joint. In some instances, the surgeon may have to reshape a damaged glenoid.

In a 2019 issue of the Journal of Shoulder and Elbow Arthroplasty, scientists report positive results in new shoulder replacement techniques that rely on specially designed, non-spherical elements – like that provided by the Catalyst system. These implants, authors say, cap the ball at the top of a diseased forearm bone – the humerus — with high precision, preserving the bone’s anatomical relationship with the glenoid, the socket of the shoulder blade, and allowing little deviation of the joint during shoulder movement.

“The Catalyst technique uses cutting guides to achieve a consistent, calibrated bone resection, which matches the thickness of the humeral head component,” said orthopedic surgeon and Catalyst OrthoScience founder Steven Goldberg MD in a recent news release. “Additionally, the non-spherical design of the humeral component better replicates the natural shape of the humeral head.”

Other advantages of partial shoulder replacement: the procedure is more conservative than total joint replacement, requires a smaller incision, results in less pain, offers quicker recovery, and the implant may prolong the function of the joint and help the patient avoid future total shoulder joint replacement. Dr. Badia adds that “patients who undergo partial shoulder replacement with a stemless implant are driving a car within a matter of weeks and, within a few months, back to golfing, tennis or other athletic activities.”

Dr. Badia cautions, however, that not every shoulder patient is a candidate for partial joint replacement. Total joint replacement or reverse shoulder arthroplasty may be necessary if the patient is of advanced age or the shoulder disorder involves a rotator cuff tear; structural damage – like a fracture — to the ball-and-socket joint; or presence of extensive disease, including inflammatory arthritis, osteonecrosis, and post-injury degeneration of the joint.

Meanwhile, Dr. Badia offers these tips to prolong the integrity of the shoulder joint:

• Keep in generally good shape, especially when performing physically demanding work.
• If the job requires long stretches at a desk, maintain proper posture—back straight and feet on the floor. No slouching.
• Ensure your workstation is ergonomically arranged and take frequent breaks even if that means simply standing up and doing some stretching.
• Warm up slowly – and properly — before exercising or engaging in athletic activities, particularly those placing demand on the shoulder joint like golf and tennis.
• Use correct lifting techniques and reposition ladders or stools to avoid straining when reaching for what you need.

And whatever you do, avoid constantly aggravating a painful shoulder joint. Get it checked by an orthopedic specialist. Joint disorders are like leaky faucets. They do not repair themselves. They need an expert,” Dr. Badia advises.

Bio: Alejandro Badia, MD, FACS, is an internationally renowned hand and upper-limb surgeon and founder of Badia Hand to Shoulder Center and OrthoNOW®, a network of walk-in orthopedic centers. Dr. Badia is the author of Healthcare from the Trenches.

Catalyst OrthoScience develops innovative medical solutions that make orthopedic surgery less invasive and more efficient for both surgeons and patients. Catalyst was founded in 2014 by orthopedic surgeon Steven Goldberg, M.D., who saw the need to make shoulder replacement surgery less invasive and give patients a more natural-feeling shoulder after surgery.

The Catalyst CSR Total Shoulder System is unique, offering precision and accuracy in shoulder restoration while preserving the patient’s bone and soft tissue. The Catalyst CSR is a single-tray, bone-preserving total shoulder arthroplasty system containing a precision elliptical humeral head and less invasive glenoid component, using patented instrumentation designed for consistent anatomic joint line restoration and glenoid insertion. The Catalyst CSR system can be used in both inpatient and outpatient settings and was cleared for use by the FDA in 2016.

Catalyst OrthoScience has a growing portfolio of U.S. patents with several more pending nationally and internationally. The company is headquartered in Naples, Fla., and its products are available across the U.S. For additional information on the company, please visit http://www.CatalystOrtho.com.