Paper 2 - Introduction As a ball and socket joint the...

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1 Introduction As a ball and socket joint, the shoulder joint is one of the most versatile joints in the human body. In a normal shoulder, the head of the humerus glides against glenoid socket in the shoulder blade (scapula), and these joint surfaces are normally covered with smooth cartilage. This mechanical system of the shoulder allows it to rotate through a larger range of motion than any other joint in the human body. However, these are also the very reasons why failure of the shoulder joint can occur. Too much gliding can wear away the cartilage, causing the shoulder to deteriorate. 1 Arthritis can also cause cartilage loss, and like any other joint, the shoulder can fail by fracture under stress or fatigue or by disease. All of these shoulder defects usually bring pain and limited mobility to the patient. In these circumstances, a replacement shoulder joint could be the means to a higher quality of life. The recommended replacement prostheses depend on a variety of factors including the type of failure that occurred, the preoperative condition of the bones and muscles of the shoulder, and the age of the patient. In the future, there may be one superior method for all shoulder replacement surgeries, but as of today, doctors must look at the options available and choose the method and device which they feel would best increase each individual patient’s quality of life. Body
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As previously mentioned, like many other joints, shoulder joints are susceptible to failure. The most common causes of this failure are arthritis, disease, or fracture. Failure from arthritis comes in many forms including osteoarthritis, degenerative joint disease, rheumatoid arthritis, arthritis after injury (traumatic arthritis), arthritis after previous surgery (capsullorhaphy arthritis), and arthritis following infection (septic arthritis). 2 Diseases of the shoulder joint include avascular (head) necrosis and cuff tear arthropathy. Avascular necrosis occurs when the bone of the humeral head dies from a lack of blood supply and cuff tear arthropathy occurs when the rotator cuff muscles degenerate to a point where they can no longer hold together the shoulder joint or allow it to function normally with arthritis. 3 Lastly, the head of the humerus bone can fracture as a result of a hard fall or traumatic experience. The symptoms for these types of failure are usually first expressed by the patient and then verified by the doctor through x-rays. Patients with shoulder failures often complain of pain (that does not cease with non-operative treatment like pain medication and/or rest), stiffness, grinding, locking up, catching, weakness and decreased range of motion. 1 The consequent x-ray of these patients would point toward either fracture, arthritis, or disease, usually showing a decreased cartilage joint space, loose pieces of
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