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When a Fall Leads to Total Joint Replacement

POSTED BY: Florida Hospital

After falling at home recently, 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

Florida Orthopaedic Institute shoulder specialist Mark A. Mighell, MD, AAOS, AOA, CDR, USNR, says this type of replacement is now performed even more frequently than conventional replacement. “Reverse shoulder replacement has become more common due to an aging population and the potential for patients to regain function faster,” he said.

A conventional shoulder replacement mimics the normal anatomy of your shoulder: a plastic "cup" 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.

Reverse total shoulder replacement also 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, but that’s just one of the injuries that may create need for a total joint 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
  • Severe shoulder pain and difficulty lifting your arm away from your side or over your head
  • A complex fracture of the shoulder joint
  • A chronic shoulder dislocation
  • A tumor of the shoulder joint
  • Tried other treatments, such as rest, medications, cortisone injections, and physical therapy, that have not relieved shoulder pain

“Patients who have shoulder fractures, rotator cuff tears, advanced bone loss, poor bone quality, or a failed prior shoulder replacement are excellent candidates for reverse shoulder replacement,” says Dr. Mighell. “The reverse shoulder replacement is able to provide reliable pain relief and functional improvement in challenging cases that would be less reliably treated with a conventional replacement.”

Rehabilitation and Recovery

Justice Sotomayor will rest and recuperate for a few weeks while wearing a sling, then participate in physical therapy for several months. This is a common recovery plan for those with total joint replacement.

Dr. Mighell explained that most patients who have this surgery will also get X-rays during their recovery period, “to assess bone healing in the case of a shoulder fracture as well as successful ingrowth of the prosthesis.”

Physical therapy after surgery is essential for regaining function. “Patients begin working on range of motion exercises after 6 weeks,” said Dr. Mighell. “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.

To learn more about shoulder joint replacement at Florida Hospital visit here