Joint Replacement
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History
The first recorded attempt of shoulder joint replacement occurred in 1892 in a patient suffering from severe arthritis (1). In terms of the actual device, it is better to describe the evolution of the shoulder implant design in terms of generations (2): The first generation of shoulder implants were the “Monoblock” shoulder implants. These began in 1953 and consisted of a single piece – the head of the humerus could not be moved, and thus rarely “fitted” the patient perfectly.
The second generation of shoulder implants, named the “Modular Prosthesis,” had independent segments for the head and stem. These were better adapted to the individual patient anatomies because alternative head and stem parts could be chosen.
The third generation of shoulder implants were called the “Anatomical” generation. This is due to the fact that they have increased similarities with the actual anatomical shoulder. They were much more adapted to each individual patient's anatomy and do not hinder the mobility of existing muscles, tendons, and ligaments.
Modern shoulder replacement joints look very similar to the structure of the ball and socket of the actual shoulder. The head and stem provide a new surface for the bones and are either bonded to the existing bone structure within the patient through ingrowth, or by using bone cement.
Currently, many people view total shoulder replacement as a successful way of remedying arthritic pain and joint stiffness. The duration of the implant changes with the types of patients, and many different variables need to be taken into consideration, such as age, activity level, the status of the patient prior to the surgery, the type of disease the patient is being treated for, the type of surgery, and the type of implant.
Created by: Blair Smith, Connie Lee, Daniel Solomon, Matthew Whitson and Stephanie Chang
Date last modified: 5/2/2004