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Joint replacements mean better life for some, but they aren't the first option, doctor says

 

Phyllis Deiters knew she had to do something when she couldn't lift her right arm high enough to shampoo her hair.

The 82-year-old Roosevelt Park woman had had two surgeries on the muscles and tendons surrounding her right shoulder and did physical therapy for about a year, but all measures failed to relieve her pain or let her lift her arm higher than her chest. So she decided to try what she thought was a more drastic measure: having a total shoulder replacement.

“Not being able to use my arm, you can't live like that,” she said.

Now, about four weeks after her surgery, she can wash her hair again and is starting to regain normal function.

Phyllis Deiters, 82, performs an exercise with the help of Kevin E. Sprague, P.T., of Diversified Physical Therapy, in her Roosevelt Park home on July 20. Deiters does the rehabilitation exercises, which help increase range of motion in her shoulder, three times per week. She had reverse total shoulder surgery on June 23.  

“That's one thing checked off my list,” she said. “I'm just waiting to drive the car.”

Mercy Hospital in Muskegon performed 249 shoulder replacements in 2010, along with 311 hip replacements and 596 knee replacements.

Nationwide, shoulder replacements are less common than knee ad hip replacements. There were 10.3 total hip replacements, 10.9 partial hip replacements and 23.0 total knee replacements per 10,000 people in 2006, according to the National Center for Health Statistics, and those numbers are expected to increase because of the aging and increasingly overweight U.S. population.

Dr. Jeffrey Recknagel of Orthopedic Associates of Muskegon, Dieter's orthopedic surgeon, said he recommends patients wait as long as they can before getting a joint replacement, because the plastic components of a new joint deteriorate over time. Dieter's type of joint typically lasts about 10 years, he said.

“I usually send patients away with the idea, live with it as long as you can and you'll know when you're ready,” he said.

The “ready” point varies because patients have different pain tolerances and goals, Recknagel said. Some want to get back to playing sports, while others just want to do everyday tasks.

“There's something to be said for replacing a joint while you're still young enough to enjoy it,” he said.

Dr. Jeffrey Recknagel demonstrates one of his shoulder replacement models at Orthopedic Associates of Muskegon.  

The key to healthy joints is a healthy lifestyle overall, Recknagel said. Supplements can help somewhat, he said, but they don't keep joints mobile.

“The best thing to do to preserve those joints is to stay active,” he said.

For shoulders, that means simple exercise like “windmill” motions with the arms, reaching across the front of the body and touching the back. For knees and hips, it can just mean walking and maintaining a healthy weight to minimize stress on the joints.

When less intensive measures like exercises and steroid injections fail, though, it may be time for shoulder replacement surgery, Recknagel said. Despite the term “replacement,” doctors don't remove the whole joint, but resurface the bones.

Most of the time, surgeons put a plastic socket on the shoulder blade and replace the top of the upper arm bone with a metal half-sphere, which fit together like a “golf ball on a tee,” Recknagel said. In some cases, like Dieter's, the surgeon has to put the socket on the arm and the ball on the shoulder blade because of damage to the rotator cuff.

Dieters said the replacement was less painful than she expected, and she is recovering faster than she did from her previous shoulder surgeries. She still takes prescription pain medication once daily and uses ibuprofen as needed.

“It's amazing it's not more painful,” she said.

She has physical therapy three times a week. The exercises include touching her forehead and the side of her head, and tracing figure eights on a table with her arm.

“I would recommend (people with shoulder problems) to do it if they want to keep the use of their arm, and by use I mean lifting dishes out of the cupboard, shampooing your hair,” she said.

 

Above info is taken from : http://www.mlive.com/news/muskegon/index.ssf/2011/07/joint_replacements_mean_...

 

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