Shoulder replacement in Iran: all you need to know

Total shoulder replacement surgery or shoulder arthroplasty is a procedure for those with unbearable pain in the shoulder area. Typically, this procedure is recommended for aged people with the shoulder joint cartilage worn away. In this surgery, the damaged parts of the joints are replaced by artificial ones made of metal and plastic. It is important to know that after the surgery, not only the pain fades away, but also some activities become possible; such as swimming, individual training, and golf. Please read on to learn all about this procedure in general and what it would be like to have a total shoulder replacement in Iran, in particular.

First of all, how does your shoulder joint work?

The shoulder joint is one of the most complex joints of the body. It consists of a ball and socket which connect the two bone at the shoulder area to each other. The ball is called humeral head or humerus and the socket is the glenoid. The ball-socket junction provides the shoulder’s mobility. There are also tendons, bones, and muscles helping the joint to function properly. The end of the joint is covered by cartilage which is responsible for shoulder’s flexibility as it has a soft tissue compared to the bony structure of the shoulder’s ball and socket.

Why is a total shoulder replacement needed?

There are several reasons why people need to undergo a total shoulder joint replacement after trying medication or physical therapy with no considerable relief. Some of them are:

• Osteoarthritis: people usually start to have this specific arthritis after reaching the age of 50. In this condition, the cartilage wears away and they feel unbearable pain in their shoulder area.
• Rheumatoid arthritis: rheumatoid arthritis refers to the condition in which the sufferer loses the cartilage of their shoulder joint as a result of synovial membrane inflammation. Then, the shoulder becomes stiff and painful, restricting the movement of the joint.
• Post-traumatic arthritis: there are some specific injuries, like fractures, causing the cartilage, tendons, and ligaments damage. They need immediate attention and usually should be treated with a shoulder joint replacement.
• Rotator cuff tear arthropathy: muscles and tendons surrounding your shoulder joint are called rotator cuff. When one or more muscles are injured, partial or complete rotator cuff tear happens. As a result, shoulder joint changes, causing arthritis and severe pain. This condition should be treated through medications, physiotherapy, or surgery.
• Avascular necrosis (osteonecrosis): when blood does not reach bones, the shoulder joint is destructed since that bone cells’ life is dependent closely on blood supplies.
• Severe fractures: when the head of the upper arm bone is broken due to a severe fracture, it requires a total shoulder replacement surgery.

Types of shoulder surgery

Depending on your condition, your doctor may recommend you to go for physiotherapy or surgery. For surgery, there are four different types of shoulder arthroplasty procedures:

1- Total shoulder replacement

Total shoulder arthroplasty is necessary when all of the cartilage in your shoulder joint is damaged. The patients suffer from severe pain and cannot move their arm easily. They also cannot lift objects and their range of motions are restricted. In this condition, a total shoulder joint replacement is a must.

How is a total shoulder replacement performed?

Under either general or regional anesthesia, one incision is made on the front muscle of the shoulder. The arthritic surface of the humeral head is removed and an artificial metal is replaced. Orthopedic surgeon blocks the artificial joints by either cement, implants, or impacting grafted bones, which have been removed. The socket or glenoid is resurfaced by smooth plastic. These components are put into their places and fastened by cement. The next step is to close the incision by sutures or staples and placing a bandage on your wound.

2- Partial shoulder replacement

The partial shoulder joint replacement surgery is a procedure used when the head of your joint is damaged. It removes and replaces the ball with a prosthesis. This procedure is also known as shoulder hemiarthroplasty.

3- Reverse shoulder replacement

For patients suffering from the torn rotator cuff, a reverse shoulder replacement is usually the best option. In this procedure, the ball and socket are replaced but in a way that the structure of the shoulder is reversed.

4- Shoulder resurfacing

When the surgeon does not replace your joint with a prosthetic ball-and-socket joint, he might recommend a  shoulder resurfacing as an alternative. In this operation, the damaged head is manipulated and resurfaced with a metallic head.

Shoulder replacement recovery: what to expect?

You will have a recovery period of 2 to 4 weeks after you get your surgery done. The first 3-5 days may be spent in the hospital. You’ll need to take 2-4 weeks off from work and at least after 3 months, you’ll be able to go back to your sports activities. During the first few weeks, you should expect to feel pain and discomfort. Your arm will be in a sling up to 4 weeks. You’ll need to have someone at home to help you with your daily activities. In case of traveling to Iran for your surgery, rest assured that we’ll provide you with assistance during the time you’re in the country.

What to do before a total shoulder arthroplasty?

• Consult your family physician for a complete physical examination;
• 2 weeks before your surgery, stop these medications if ordered by your surgeon; such as blood thinners, non-steroidal anti-inflammatory medications, and arthritis medications;
• Organize your home in a way that stuff be easily accessible during your recovery. You can put them in the lower cupboards;
• Blood test, MRI, and bone scan may be needed;
• Medical history is required;
• Make sure there is someone to look after you and support you in your daily works, such as bathing, dressing, and cooking. If not, a rehabilitation facility is a good option;
• 12 hours before the surgery, stop drinking and eating;
• Alcohol must be stopped 1 month before; and
• Stop smoking.

What to do after a shoulder arthroplasty?

It is specifically important to do what is listed below as it has a significant role in the result:

• Take antibiotics to avoid infection;
• Take non-steroidal anti-inflammatory drugs (NSAIDs);
• Be adherent to your physical therapy and home exercises, 2 or 3 times a day are needed within a month;
• Get the sutures removed several weeks after the surgery if needed;
• After two weeks, you can do some light physical activities;
• Avoid pressure on the shoulder, especially for getting up;
• Don’t overuse your shoulder;
• Driving is forbidden up to 2 weeks; and
• Don’t place your arm in extreme positions.

Shoulder replacement in Iran

In the first place, money is the main reason triggering the idea of traveling to another country for surgery. However, when the surgery is a major one, people usually look for the best quality treatment. This is where Iran steps in, offering effective orthopedic surgeries at the most decent prices. Iranian orthopedists and surgeons are not only well-trained but also have performed tens of thousands of successful surgeries, mostly for knee, hip, shoulder, and bone fractures. That’s why we’ve been receiving many patients from our neighboring countries during the past decades. Beyond all, as the country provides international patients with VIP services, travelers do not face any difficulty during their stay. To understand how our patients’ journeys go on in Iran, please watch our patients’ videos. You can also contact us now for a free consultation.

Shoulder replacement surgery cost in Iran

Although shoulder replacement is offered with high quality in Iran, the cost is much more affordable than other countries. Shoulder arthroplasty in Iran costs around $3,500 to $5,000. This procedure, however, costs £9,495 in the United Kingdom, between $7,000 and $21,000 in the United States, and from $ 6,500 to $15,000 in India.