Avascular Necrosis Shoulder Treatment
First-line treatment of avascular necrosis of the shoulder is thought to be avoiding further injury. Additional treatment for avascular necrosis depends on the cause of injury and its progression. For example, alcoholics and patients on corticosteroids are typically taken off these things to prevent further damage and preserve the joint.
Other mechanisms of injury may need further intervention because if more vessels are impacted, the joint will deteriorate further. The surgical management of avascular necrosis may include joint preservation to improve blood flow to the bone. Once the bone damage has progressed to a significant stage, and the bone has collapsed, shoulder replacement may be required.
The shoulder joint can either be replaced with an anatomic or reverse prosthesis. An anatomic shoulder replacement includes a metal ball to replace the humeral head and a plastic piece to replace the socket. In the reverse prosthesis, the metal ball is placed on the socket side of the joint, while the plastic ball-shaped socket is on the humeral end of the prosthesis.
The anatomic shoulder replacement is recommended in patients with avascular necrosis of the shoulder. The reverse replacement would be indicated if there was cartilage damage or rotator cuff damage, which is not common in avascular necrosis of the shoulder.
Preservation of the shoulder joint is almost always indicated before a shoulder replacement due to the complications that may arise with this kind of invasive operation. The most common complication is instability, rotator cuff tear, periprosthetic fracture, and infection. Replacement is indicated when the joint cannot be salvaged due to humeral head collapse.
Currently, avascular necrosis of the shoulder is a treatable ailment. Current research is investigating the preservation mechanisms of patients with this disease and mechanisms to prevent bone breakdown due to disease progression. With this goal in mind, shoulder replacements also have an excellent prognosis with a high success rate and the ability to regain quality of life.