Rare surgery performed at KMC Hospital, Attavar

The doctors at KMC Hospital,Attavar, performed a reverse shoulder replacement surgery recently.

According to a press release, the rare surgery was performed by an orthopaedic team headed by Dr Surendra U Kamath, Dr R A Purnachandra Tejaswi and Dr Atmananda Hegde.

Shankar (name changed), a 60-year-old electrician, would complain of being unable to use his right upper limb i.e, upper arm towards shoulder for over two years after falling from his bike. His arm and shoulder had restricted movements and he could not perform regular day-to-day activities. His symptoms worsened over the last two months as he could not sleep due to severe pain.

His condition was complicated by a childhood disorder called Myaesthenia Gravis, a systemic disorder that led to easy fatigue and weakness of his voluntary muscles of the body.

The investigations indicated that he had rotator cuff arthropathy – a condition where his rotator cuff muscle was weak leading to shoulder joint arthritis. After the surgery, the patient was put on a sling for two weeks after which gradual exercises were introduced. The patient is pain-free at present and gradually is regaining his lost arm/shoulder motion.

Dr Surendra U Kamath, head of Orthopaedics Department, KMC Hospital, Mangaluru, said, “A rotator cuff arthropathy is a condition where the rotator cuff muscles become weak and fat deposits near the joint degenerates leading to retraction of the tendon with gleno-humeral joint arthritis. The condition requires a surgery called reverse shoulder replacement.”

He said if a conventional joint replacement is used in this situation, though there may be some pain relief the humeral head usually remains upward out of the socket and elevation of the arm is impossible.

The reverse shoulder replacement changes the orientation of the shoulder so that the normal socket (glenoid) now is replaced with an artificial ball and the normal ball (humeral head) is replaced with an implant that has a socket into which the artificial ball rests. This type of design completely changes the mechanics of the shoulder and enables the artificial joint to function when the rotator cuff is either absent or when there is significant bone loss.

Dr Anand Venugopal, medical superintendent, said, “The case was challenging and complicated as this is a unique case that was performed for the first time in Coastal Karnataka.”