Rare reverse surgery performed by city doctor on Bhubaneswar patient
Patient P. Nair with Dr A.K. Venkatachalam after the surgery. (Photo: DC)
Chennai: A reverse shoulder replacement surgery, performed by a city doctor, restored mobility to a patient from Bhubaneswar, who has been suffering from pain on her left shoulder for the last 15 years. Rheumatoid arthritis affects all the synovial joints. It ultimately leads to joint damage and bone destruction. While painkillers and disease-modifying drugs may be useful in the early stages, joint replacements are the only way to cure the affected joints. Multiple joint replacements are required to keep the patient mobile.
The patient, Ms P. Nair, was suffering from widespread rheumatoid arthritis and could get solace from the treatment she got earlier. After she approached Dr A.K. Venkatachalam, consultant orthopedic surgeon at Meenakshi multi-speciality hospital, Mylapore, here, CT and MRI scans helped to detect advanced bone and soft tissue destruction from rheumatoid arthritis.
As the bony destruction was advanced, Dr Venkatachalam, decided on the basis of the scan reports that a reverse shoulder replacement was the only option left to ameliorate her condition. He performed a rare reverse shoulder replacement surgery that lasted for two-and-a-half hours and restored mobility. The normal position of the ball in a shoulder joint is at the upper end of the arm bone while the socket is at the outer end of the shoulder blade.
In this operation, the position of the two is reversed with the ball being shifted to the shoulder blade and the socket to the upper end of the arm bone. The centre of rotation is shifted more outward and this makes the Deltoid muscle more effective. The back of the un-cemented ball is coated with a ceramic material to allow osseo-integration with the patient’s own bone. The ball will biologically integrate with her shoulder blade. The socket is cemented into the arm bone.
“The patient has recovered well and will be discharged in a day. She will be totally pain free and recover full mobility after a course of physical therapy. A reverse shoulder replacement calls for advanced skills and training in shoulder joint replacements,” says Dr Venkatachalam, who, in 2008, had performed bilateral knee replacements to help her walk.
( Source : dc correspondent )
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