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First case in India of Reverse Shoulder Replacement for failed shoulder fracture fixation, was performed by Dr. Anand Jadhav, Joints Super-specialist, who was once honoured for Excellence in 'National Health Service' by British Prime Minister, Mr. Tony Blair

Press Release, Pune, India

A Revision Surgery in the form of Reverse Shoulder Replacement on a case of failed shoulder fixation was performed for the first time in India by Joints Superspecialist, Dr Anand Jadhav during the third week of February 2011, in Pune.

Male patient in late 50s, had undergone internal fixation of the fracture of upper end of humerus (arm bone), more than a year ago. He had sustained this injury after a fall. Fixation surgery was performed using imported locking plate and screws. Patient was undergoing rehabilitation as planned, but due to osteoporosis, the fixation failed. Following this, the patient started getting pain with severe limitation of movements. This caused great difficulties with his activities of daily living and work.

Clinical examination and x-ray findings suggested that the fracture fixation had failed with the screws cutting out of the soft (osteoporortic) bones. There were features of secondary damage to the rotator cuff tendon as well.

A Revision Surgery in the form of Reverse Shoulder Replacement was considered the most suitable option for this patient, as this would allow the patient to become pain-free and have good functional movements inspite of damage to the rotator cuff tendons.

Dr Anand Jadhav has acquired the training and skills of Reverse Shoulder Replacement from leading Shoulder Surgeons in France and USA 5 years before this technology was approved in India. His skills have enabled him to perform this complex and challenging revision surgery for the first time in India. This surgery was performed by Dr Jadhav in a good private hospital of Pune, Maharashtra. Specialised instruments and implants from a French company were used in this surgery. This is a milestone achieved in the history of Joint Replacement, in India.

Reverse Shoulder Replacement is relatively easy to do in a primary setting (shoulder replacement surgery for the first time) in a patient with arthritis due to torn rotator cuff tendons as compared to a Revision Surgery case of Reverse Shoulder Replacement for failed fracture fixation or failed standard shoulder replacement. Such cases are always a challenge for revision due to extensive soft tissue scarring and lack of normal anatomy of bones & surrounding soft tissues.

Reverse Shoulder Replacement Surgery is a technically demanding surgery. It is normally indicated in patients who have arthritis due to torn rotator cuff tendons (Cuff Tear Arthropathy). However, it needs a normal deltoid muscle for functioning of the new joint.

During Reverse Shoulder Replacement Surgery, the position of the ball and socket are reversed as compared to a normal joint. A new ball, called glenosphere is fixed to the shoulder socket (glenoid), while the humeral head (end of the arm bone) is replaced with a mobile shoulder socket. This socket sits on top of a metallic stem implant inserted into the humerus. This joint is primarily moved with the help of deltoid muscle.

A Reverse Shoulder Replacement can be performed for revision of cases with failed standard shoulder replacements or for severe fractures of the upper humerus where damage to the rotator cuff is also present.

Patient is now pain-free and undergoing structured physiotherapy.

Dr. Jadhav feels that Reverse Shoulder Replacement is a blessing for patients with cuff tear arthropathy as well as failed previous surgery and rotator cuff damage.