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When a Fall Leads to Total Joint Replacement

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When a Fall Leads to Total Joint Replacement

After falling at home, Supreme Court Justice Sonia Sotomayor suffered an injury to her left shoulder that required a reverse total joint replacement surgery. Though it may sound unusual, this type of procedure is a common, effective way to help you recover mobility and comfort after a serious injury. We’re sharing what this procedure involves and when your physician might recommend it for you.

Since falls can cause a wide range of injuries, working to prevent them is a smart way to decrease your likelihood of ending up in the hospital in the first place. Read on to find a few tips for making your home and everyday routine as safe as possible.

Understanding Reverse Joint Replacement

A conventional shoulder replacement mimics the normal anatomy of your shoulder: an advanced plastic "implant" is fitted into the shoulder socket, and a metal "ball" is attached to the top of the upper arm bone. In a reverse total shoulder replacement, the locations of the socket and ball are switched to allow for improved biomechanics in situations where the rotator cuff muscles are not functional. Reverse total shoulder replacement relies on the deltoid muscle, instead of the rotator cuff, to power and position your arm.

Conditions That Might Require Total Joint Replacement

Justice Sotomayor suffered a complex fracture as a result of her fall in spring 2018, but that's just one of the injuries that may create need for a reverse total shoulder replacement. This type of surgery may be recommended if you have:

  • A completely torn rotator cuff that cannot be repaired
  • Cuff tear arthropathy
  • A previous shoulder replacement that was unsuccessful
  • A complex fracture of the shoulder joint
  • A chronic shoulder dislocation
  • A tumor of the shoulder joint

“The reverse shoulder replacement, first approved for use in the United States in 2004, has been a tremendous advancement in shoulder surgery to provide pain relief and improvement in function for those patients who do not have a functional rotator cuff or have suffered complex shoulder injuries.”

Robert E. Boykin, MD

Rehabilitation and Recovery

For shoulder replacement surgery patients, like Justice Sotomayor, there is a recuperation period for a few weeks while wearing a sling, followed by several months of physical therapy.

Physical therapy after surgery is essential for regaining function. Patients begin working on initial range of motion exercises after 2 weeks. By 3 months, they usually have made significant improvement compared to their pre-op state. It’s common to continue improving up to one year after surgery. Most patients will regain the full range of motion needed to perform activities of daily living.

Fall Prevention Tips

According to the Centers for Disease Control and Prevention, more than one in four older people (age 65 and over) falls each year, but less than half of them tell their doctor. This is dangerous as they may be living with an injury that could require surgery or rehabilitation. In fact, one out of five falls causes a serious injury like a broken bone or head injury.

Here are a few ways you can decrease your likelihood of falling:

  • Get an annual eye examination
  • Have your doctor review your medications for potential side effects of dizziness or weakness
  • Reduce tripping hazards in the home like slick floors, loose rugs, and cluttered pathways
  • Wear sturdy, well-fitting shoes and avoid walking in socks or stockings
  • Add grab bars around your toilet and shower and hold the railings when using stairs
  • Keep up your stability and coordination as much as possible through exercises like yoga or Tai Chi

If you suffer a fall, take a deep breath and remain calm. Carefully move to a phone and call 911 or a family member for help.

Learn more about our Orthopedic Care and how we can help you restore your vibrant, active life here.

Robert E Boykin, MD

Robert E. Boykin, MD

Robert Boykin, MD is an orthopedic surgeon with EmergeOrtho Blue Ridge Division. Dr. Boykin is fellowship trained and specializes in shoulder surgery and sports medicine. He also serves as a Co-Managing Physician of the Orthopedic Surgery Program at AdventHealth Hendersonville.

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