Shoulder replacement / Top clinic in Germany, Friedrichshafen

Shoulder replacement

The orthopedic department of Friedrichshafen Clinic in Germany is headed by an experienced orthopedic surgeon, Prof. DM Winter.

During the period between 2005 and 2013 our doctors have performed about 1500 surgeries for total and partial shoulder joint replacement.

Shoulder replacement is indicated in shoulder joint destabilization, when the conservative therapy doesn't give an expected effect.

Indications for shoulder replacement

Please note that only the qualified specialist can judge about the indications for the joint surgery. After a thorough examination of the patient the diagnosis and indications for the surgery are discussed with the patient. The joint replacement cost may also be judged only after tests and consultations.

Age, the degree of functional impairment, type of activity and individual preferences are the key factors which should be taken into account when deciding about the type of surgical joint replacement.

  • Various humerus fractures;
  • Shoulder pain;
  • Necrotic process in upper arm bone;
  • Non-physiological synosteosis of bones that form shoulder joint;
  • Dystrophic pathology of a shoulder joint;
  • Severe damages caused by hematoid process;
  • Genetic shoulder pathologies;
  • Joint instability due to other pathologies that is not cured by other methods;
  • Fracture of the shoulder joint;
  • Dislocation of the shoulder joint;
  • Tendon rupture;
  • Bursitis;
  • Calcific tendinitis;
  • Arthrosis of the shoulder joint in its advanced stage;
  • Arthritis of the shoulder joint;
  • Osteonecrosis of the humeral head.
Shoulder replacement

Shoulder joint surgery: When is an OP worthwhile?

Everyday life can wear shoulder joint

Wear on the shoulder joint often results in severe pain and limited mobility. When surgery on the joint promises to improve.

If you followed the spectacular stunts of the Olympic gymnasts on television, you could see how extremely stressed the shoulders are. Forces that are about five times your own weight tug at your joints with your swinging momentum. People who are intensively involved in arm-poor sports are often worn out at an early age.

But even with normal everyday movements, the shoulder joints wear off - but usually not so fast. Millions of people in Germany are familiar with the symptoms of wear: pain, loss of strength, stiff joints.

When is shoulder joint surgery useful?

Hundreds of thousands of patients opt for an intervention on the shoulder joint every year. Orthopedic surgeons then mend damaged tendons, remove bone fragments, repair ligaments and connective tissue, insert replacement joints. Since not all of this is systematically recorded, there is no data on how many shoulder operations altogether come together.

But how even experienced orthopedic surgeons recognize where the cause of the discomfort lies and whether a surgical procedure on the shoulder is necessary at all? The beginning is always the medical history and the physical examination. Prof. Dr. explains: "First of all, I let my patients move their aching shoulders, and the comparison with the healthy joint quickly gives me a first idea. For foreign patients, the transmitted X-ray and MRI images are evaluated first. Then an invitation to a personal conversation takes place."

Mostly the rotators torment us

Then the doctor himself lends a hand, performs various functional tests. For example, he lets the patient raise and twist his arm against resistance. Winter: "If these movements in the shoulder hurt or the strength is missing, this indicates problems with the rotator cuff." This muscle group hugs the shoulder joint and controls most of its movements. This makes the rotators susceptible to wear and other pathological changes. They are also the target of most surgical procedures on the shoulder joint.

Before orthopedists recommend surgery, they get an accurate picture of shoulder damage, such as ultrasound, X-ray and MRI examinations. The latter represent details of tendons, muscles and ligaments. However, it takes a lot of experience to interpret all results correctly.

Decompression does not solve all problems

"In the meantime, people know that this is going past the actual target - at least for many patients," says Winter. Often after a decompression the pain remains in the shoulder joint - because there are other or other causes for the complaints. Tears of the rotator tendon or the lower biceps tendon, for example, limescale deposits or wear in the so-called shoulder joint, the link between arm and trunk. Nevertheless, decompression is not necessarily wrong, says Winter. "But if you do it, you should also fix the other problem makers." This assumes that they have been detected before.

Shoulder replacement in Germany: preparation for surgery

This phase includes the research of the patient's condition and individual implant selection. If there are any infections found, a patient is prescribed with proper therapy to avoid the post-surgical infectious complications.

A patient undergoes the following tests before the shoulder replacement surgery:

  • Common blood and urine analysis;
  • ECG for detecting heart pathologies that may be contradictions for the surgery;
  • Joint X-ray;
  • CT, MRI as necessary.

Types of shoulder replacement at Friedrichshafen Clinic

  1. The surface arthroplasty of the shoulder joint
  2. Shoulder hemiarthroplasty is a shoulder replacement in which the broken humeral head is replaced with an artificial joint whereas the fractured bone is restored around the artificial joint.
  3. The total joint replacement of the shoulder joint, i.e. a complete replacement of the contacting joint surfaces. There are two variants of total joint replacement: a) replacement of the articular joint surfaces (Partial resurfacing arthroplasty - PRA) and b) the implementation of prosthetic devices (Total Shoulder Arthroplasty - TSA). The cost of a total shoulder implant varies, depending on the type of implant used. The estimate cost of joint replacement makes up 15 000-20 000 euro.
  4. Revision arthroplasty of the shoulder joint - surgery to replace an existing prosthesis or its worn components.

The shoulder replacement lasts no more than 2 hours and is performed with minimally invasive techniques. The overall recovery period after the partial shoulder joint replacement lasts about 3 months. Such an operation would cost about 7 000- 10 000 euro.

Interfacial shoulder replacement

Our doctors in Germany use this method to replace the damaged cartilage zone of humeral head without replacing the bone. The surgery implies the installation of metal implant on the humeral head area.

This approach is reasonable when there are no pathologic changes in stabilizing muscles and in shoulder pocket area. The result of the hemiarthroplasty is increasing the motion amplitude by 40 degrees and more in any directions.

Interfacial endoprosthesis replacement is an optimal variant of shoulder replacement, if there are no contradictions.

Total shoulder joint replacement

This surgery is aimed at the replacement of both glenoid cavity and humeral head. It is indicated in heavy damages of bone, joint and muscle elements.

During the surgery humeral head is totally removed, stripping the bone marrow. The inner part of the bone is prepared, and prosthesis is implanted into it. The implant's core is put into the bone cavity and is fixated by cement or by cementless method. The glenoid cavity is replaced by soft plastic element. Our clinic in Germany provides modern implants that are similar to natural joints in terms of motion range.

Reverse shoulder replacement in Germany

Reverse endoprosthesis replacement of shoulder joint is indicated in mechanical shoulder dysfunction due to rotator cuff breakage.

An endoprosthesis is implanted during a surgery. The implant's spheroid joint is localized on the top of shoulder bone. Therefore the motions in shoulder joint will be made by a fully-featured deltoid muscle instead of the damaged muscles of shoulder girdle.

Shoulder joint replacement: the process of surgery

  • General anesthesia is required, endotracheal anesthesia is preferable;
  • A surgeon performs the dissection of soft tissues that cover the shoulder joint;
  • The pathologic parts of humerus and glenoid cavity are removed, preparing a place for an endoprosthesis, a cement is put into the bone foramen;
  • The selected shoulder joint prosthesis is installed;
  • A surgeon restores the integrity of tissues and fixates the joint.

Rehabilitation after shoulder replacement

During the first 6 weeks after the surgery a patient needs to develop motions in shoulder joint by a passive way. In 6 weeks after surgery active exercising is allowed. Physiotherapy brings great results.A patient returns to his normal life in 12-24 weeks, when the joint becomes fully functional. Labor activity, swimming, gold and other sports are allowed.

If you need to undergo shoulder or any other joint replacement, welcome to our clinic in Germany. Experienced specialists will perform high-quality diagnostics, select optimal joint model and will take care of proper rehabilitation.

Shoulder replacement

3.9/5 (172 votes)

Comments and questions

Zachar Antonovsky Mon, 11 Sep 11:49

Hello,
I am a 55 yo male from Moscow, Russia. I have constant pain in my left shoulder and local doctor recommended total shoulder replacement, or as an option - a resurfacing type arthroplasty. I would like to get a second opinion and if confirmed, perform the procedure at your clinic.
I plan to be in Friedrichshafen for Fakuma exhibition during KW 42. Can a consultation with Dr. Winter be scheduled?

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Medical Staff

Prof MD Eugene Winter

Prof MD Eugene Winter
Head of the Orthopedic Department of Clinical center of Friedrichshafen

MD Norbert Heuer

MD Norbert Heuer
Head physician assistant

MD Christoph Kaiser

MD Christoph Kaiser
Senior physician

MD Rainer Schnell

MD Rainer Schnell
Senior physician

Ingrid Glauss

Ingrid Glauss
Medical secretary

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Facts and Figures

  • 12000 outpatient
  • 2523 inpatients
  • 2500 surgeries
  • 735 arthroplasty of the joints of the hip, knee and shoulder
  • 1500 hand surgeries

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