The shoulder is a complex joint consisting of a number of bones, ball, socket, and cartilage. For people suffering from arthritis of the shoulder joint, a total replacement of the shoulder joint is often a successful procedure. It significantly improves pain and range of motion. However, in case the patient is suffering from a special type of arthritis of the joint known as  cuff tear arthropathy , a total shoulder replacement often does not produce the desired result. These people suffer from large rotator cuff tear as well as arthritis. For such patients, a reverse shoulder arthroplasty often show better results. 

Reverse Shoulder Arthroplasty 

In traditional total shoulder replacement, the device put into the joint consists of a plastic cup fitted into the glenoid bone, also known as the socket, and a metal ball attached to the top of the humerus, the upper arm bone. In a way, it mimics the configuration of the original shoulder joint. However, in case of reverse shoulder arthroplasty, the positions of the metal ball and the socket are interchanged. The plastic cup is attached to the humeral head whereas the metal ball is attached to the glenoid bone. 

Benefits of the Procedure 

A reverse shoulder arthroplasty works better for patients who have a large rotator cuff tear along with arthritis. There are a number of rotator cuff muscles in the shoulder and they help to hold the arm in position as well as provide power to the arm during extreme movements. In case of people with large rotator cuff tear and arthropathy, the upper arm has to rely on different muscles for movement because the rotator cuff muscles don t function. Hence, the arm has to depend on other muscles such as the deltoid muscles, to position and power the arm. This is why a reverse arthroplasty is carried out.

Who Can Undergo This Surgery?

Every patient with cuff tear arthropathy is not a candidate for reverse shoulder arthroplasty. Surgeons recommend this surgery when the patient is suffering from: 

  A total tear of the rotator cuff which cannot be repaired 

  A special type of shoulder arthritis known as cuff tear arthropathy 

  An unsuccessful shoulder replacement surgery 

  Extreme shoulder pain along with difficulty in lifting the arm over the head or away from the body 

  A complex type of fracture in shoulder joint 

  A chronic dislocation of the shoulder 

  A tumor in shoulder joint 

Doctors can also suggest this procedure if the patient had previously tried other remedial measures such as medications, rest, physical therapy, injections, etc., but was not successful in alleviating the pain and improving the range of motion of the shoulder. 

Conclusion 

There are some medications that you need to stop before the surgery since they may cause excessive bleeding after the surgery. Some of these medicines are blood-thinning medicines and Non-steroidal anti-inflammatory medicines.

Revision Replacement - What Should You Know?

The shoulder is one of the most intricate joints in the body and given that it is subjected to a lot of lifting and movements, there are chances for it to tear or dislocate. The shoulder is a ball-and-socket joint with the socket in the shoulder, and the ball in the upper arm. The joint space between the two bones is surrounded by cartilage, and the space between the two is filled with fluid. Especially in athletes, due to forceful movement, this joint could get dislocated or the cartilage could tear.

The Bankart lesion is when there is a tear of the cartilage in the central anterior shoulder. This causes the cartilage to be damaged, allowing the humeral head to slip down from the socket. When the arm is extended down or to the side, it is commonly dislocated. This can happen posteriorly also, but this movement and so the injury is less likely than an anterior dislocation. If there is also a fracture of the shoulder bone with this dislocation, then it is known as bony or osseous Bankart lesion.

Causes: Bankart lesions can be acute or chronic. Acute is when there is sudden dislocation due to sports activity or accidents. Repetitive use of the shoulder can also lead to chronic Bankart lesions. This is usually seen in sportspersons like swimmers, tennis players, and weightlifters.

Signs and Symptoms:

Pain: The most common symptom with Bankart is shoulder pain that restricts any kind of movement. One may find it difficult pick up things or lifting your hands and in some cases, it is difficult to even sit straight.
Weakness: The shoulder feels weak and one is unable to perform normal activities
Instability: One may lose the grip and strength.
Limited movement: The range of motion of the shoulder may be reduced compared to before the injury.
Crackling: The damage to the fibrous cartilage produces a crackling sound, which can be heard during the movement of the shoulder.
Diagnosis: A combination of symptoms, physical examination, X-ray, and MRI can help in confirming the diagnosis.

The course of treatment depends on the cause and condition of the patient. An exercise regimen is prescribed as the first step in the treatment process. If there is inadequate progress, or if the pain seems to be recurrent, open or closed shoulder surgery may be recommended to include the following:

Arthroscopy (closed surgery) to repair the cartilage damage
Ligament re-attachment
Bone reshaping
Cartilage build up and reshaping
Ligament repair to improve stability
Any of these shoulder surgeries would be followed up with measures to reduce further injury. It is therefore advised to visit a doctor in case of any such discomfort as he/she will be able to find out the severity of the situation and devise a treatment plan accordingly.

Bankart's Lesion - What Exactly Is It?

Bones are quite literally the support system of the body, so it's super important to keep them strong and healthy. Strength is not a goal you achieve in a day, week or month. It is a way more rigorous process that has to go on for years. The growing age of your life matters the most; it is at this point that you can make your bones strong. Bone strength should also be maintained in certain ways. Child or adult, you must aim for both mental and physical strength.

Here are some tips to make deposits in your bone bank for a healthier future.

1. Know your family history: as with many medical conditions, family history is a key indicator of bone health. Those with a parent or sibling who has or had osteoporosis are more likely to develop it. So, how's your bone density, grandma? might seem like an awkward question at thanksgiving dinner, but ask anyway before she passes the gravy.

2. Boost calcium consumption: when most people think bones, they think calcium. This mineral is essential for the proper development of teeth and bones. But calcium isn't the end-all, be-all bone loss cure. The key might be to help the body absorb calcium by pairing calcium-rich foods with those high in vitamin d. Foods that are good sources of calcium include yogurt, cheese, milk, spinach and collard greens.

3. Don't forget the vitamin d: where there's calcium, there must be vitamin d: the two works together to help the body absorb bone-boosting calcium. Boost vitamin d consumption by munching on shrimp, fortified foods like cereal and orange juice, sardines, eggs (in the yolks) and tuna, or opt for a vitamin d supplement. The body also produces vitamin d when exposed to the sun - 10 to 15 minutes of exposure three times per week will do. Vitamin d's importance to bone health has been proven in studies on  seasonal bone loss - elderly people can lose more bone mass during the winter because of lack of sun exposure.

4. Make exercise a priority: seriously regular exercise is to keep a number of health issues at bay, and bone health is no exception. In fact, living a sedentary lifestyle is considered a risk factor for osteoporosis. What type of exercise is most effective? weight-bearing exercises like running, walking, jumping rope, skiing and stair climbing keep bones strongest.

5. Consume less caffeine: caffeine does have some health benefits, but unfortunately not for our bones. Too much of it can interfere with the body's ability to absorb calcium. Drinking more than two cups of coffee per day accelerated bone loss in subjects who also didn't consume enough calcium. Also more than 18 ounces of coffee per day can accelerate bone loss by negatively interacting with vitamin d. So enjoy the java, but keep it in moderation and consume enough calcium, too.

6. Quit smoking: here's yet another reason to lose the cigarettes: multiple studies have shown that smoking can prevent the body from efficiently absorbing calcium, decreasing bone mass.

6 Things to Do for Strong Bones

There are 27 bones in the human hand. An injury to any one of them or a disease that affects the bones, tendons, muscles or blood vessels in the hand, are the most likely causes for pain in the hand and tenderness.

Some of the most common conditions that cause hand pain are:

De Quervain's Tendinitis: Pain on and around the thumb is the characteristic sign of this condition. This pain may develop gradually or come on suddenly and can travel the length of the thumb and forearm. De Quervain's tendinitis is caused by the swelling of wrist tendons at the base of the thumb. Repetitive actions and overuse are the most common triggers for this condition.

Carpal Tunnel Syndrome: The symptoms of carpal tunnel syndrome are felt mainly in the thumb, index finger and middle finger. This pain is often worse at night and is caused by the swelling of inflamed tendons at the base of the hand that puts pressure on the median nerve. This syndrome can make it very difficult for a person to grip objects.

Fractures: The fracture can cause extreme pain along with stiffness, swelling and loss of movement. A fracture refers to the breaking of a bone and can be of many types including simple fractures, complex fractures, comminuted fractures and compound fractures. The type of fracture dictates the type of treatment required. Spraining a muscle in the hand is another leading cause of pain in the hands.

Arthritis: This is one of the most common causes of pain in the hand that is related to ageing. Arthritis causes loss of cartilage that makes the movement of one bone against the other extremely painful. It may or may not also be accompanied by swelling. When it comes to the hand, arthritis affects the base of the thumb and middle or top joints of the fingers. Osteoarthritis may also cause bony nodules to be formed on the fingers.

Trigger Finger: This condition is also known as stenosing tenosynovitis. This condition locks the fingers or thumb in a bent position. This condition is triggered by the flexor tendons getting irritated. These tendons control the movements of the thumb and fingers. As the tendon is inflamed, the sheath that surrounds the tendons may also thicken and nodules may form of the affected tendons. People suffering from rheumatoid arthritis, gout and diabetes are at a high risk of suffering from this condition.

Pain And Tenderness In Bones Of The Hand - Factors That May Cause it!

Pregnancy places a lot of demand on the expectant mother. While the emotional demands are not very evident, the physical ones are. The mother has to ensure that the developing baby gets all the required nutrients through her. Some of them are very critical, and not getting adequate amounts of these manifest as problems, which cannot be rectified later. Calcium supply and associated problems that may arise is one such example.
If there is a reduced supply of calcium and the bones and teeth are not formed properly, taking any amount of calcium is not going to correct the situation later, after delivery.

The bones which are forming in the developing baby are dependent on the mother for adequate supply of calcium. It is common knowledge that calcium is an integral component of bones, teeth, and skeleton. Hypocalcemia, which is a condition where there is reduced amounts of calcium in the body, can be quite severe during pregnancy.
In addition to the growing baby s needs, calcium also plays a vital role in the pregnant mother for muscular contractions, nerve conduction, hormone secretion, and blood clotting. So adequate intake of calcium during pregnancy is essential.
Now, the question arises as to how much calcium is good enough. For a normal female, about 1000 mg of calcium is required on a daily basis. This goes up by another 200 to 300 mg for a pregnant woman, especially during the third trimester when the bone and teeth formation is in full speed. This extra amount of calcium should be continued even after pregnancy, as calcium continues to be provided to the baby during the lactation phase.

Some of the symptoms of reduced calcium intake during pregnancy are aching muscles, brittle nails, weakened bones, severe cramping, and dry skin. If there is suspected hypocalcemia, it is best to seek medical advice. It is not advisable to take supplements without medical supervision. Increased amounts of calcium can produce a different set of symptoms.

While these are evident symptoms, there are other detrimental effects on the baby too. Calcium deficiency affects development of heart and associated structures and puts the newborn at a higher risk of developing hypertension. The baby s fat percentage and triglycerides are also increased. The bone mineral density is reduced. The delivery period could be prolonged, as muscular contractions and nerve conduction are severely impacted when there is less calcium in the system. Recovery from labor is also delayed.

It is possible that you are taking adequate amounts of calcium, but its absorption is affected. Reducing caffeine intake helps in better absorption of calcium. Iron, which is often given during pregnancy, prevents calcium absorption and so needs to be spaced out.

Calcium & Bone Disorders - How to Know If Your Are Suffering From Them?

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases. Based on the affected bone and impact, different types of fractures are commonly identified as:

Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
Incomplete: When the breakage is incomplete, where the bone has cracked, but does not break into pieces, it is known as an incomplete fracture.
Another type would be the open or closed fracture:
Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, here are different types including hairline, greenstick, oblique, etc.
What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

Develop an exercise routine to strengthen the muscles
Manage weight
Use the right footwear and exercise gear
Watch your medications (avoid sleep inducing ones)
Increase lighting in the room/home to improve clarity of vision for elderly
Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedroom, using rubber mat, etc.
While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage.

Bone Fracture - Common Types and How They Can be Prevented?

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