Glenohumeral Arthroplasty Technique.
Last updated Thursday, January 27, 2005
Surgical approach
Glenohumeral arthroplasty provides the surgeon with the opportunity to
use all the principles related to the restoration of motion, strength,
stability, and smoothness. All adhesions and contractures must be
released and the smoothness of the nonarticular humeroscapular motion
interface must be reestablished. Obligate translation is avoided by
appropriate capsular releases. Strength is optimized by placing the
muscle-tendon units under proper tension. Stability is achieved by
normalizing joint surface orientation and providing the appropriate
geometry for the concavity compression stabilization and balance
mechanisms. Smoothness is provided by the prosthetic joint surfaces and
by immediate postoperative motion.Preparation of the patient While a general anesthetic can be used, a brachial plexus block has
the advantage of providing about 12 hours of anesthesia in the surgical
area. The patient is placed in the beach chair position with the thorax
up at an angle of 30 degrees. The shoulder is just off the edge of the
operating table so it can be moved freely through an entire range of
motion. The anesthesiologist is positioned at the side of the neck on
the opposite side from the shoulder being operated. A gowned member of
the surgical team performs a careful skin preparation including the
entire arm and forequarter, anteriorly and posteriorly. This
preparation is repeated after a change of gown and gloves. The coracoid
process (the lighthouse of the shoulder) is located. The deltopectoral
groove extending across it is identified by palpation and marked as the
line of incision.
Draping allows access to the entire scapula, clavicle, and humerus. Disclaimer
This resource has been provided by the University of Washington Department of Orthopaedics and Sports Medicine as general information only. This information may not apply to a specific patient. Additional information may be found at http://www.orthop.washington.edu or by contacting the UW Department of Orthopaedics and Sports Medicine.
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