What is Shoulder Replacement?

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What is shoulder replacement? Many patients have asked about shoulder replacement, wondering if they are a candidate for this procedure. There are several causes of shoulder pain, and not all shoulder pain requires surgery.

The shoulder and its components

The shoulder is a complex joint. It is considered a ball and socket joint, similar to the hip joint. However, the socket for the shoulder is very shallow. The shallow socket allows our shoulders to have such incredible range of motion. This same range of motion makes the shoulder intrinsically unstable. The shoulder is highly complex, with multiple tendons and structures that make movements possible. This complexity means there can be several causes of shoulder pain.

When a patient presents to the orthopedic clinic for shoulder pain, we look for these different sources:

  1. Rotator cuff tendonitis, bursitis or a tear
  2. Neck pathology
  3. Labrum tears
  4. Shoulder joint arthritis
  5. Combination of rotator cuff tear and arthritis

Assessment and treatment

We use medical history, a physical examination, x-rays and occasionally an MRI or CT scan to help us understand the cause of the pain. Shoulder arthritis and a combination of a rotator cuff tear and shoulder arthritis are the main indications for shoulder replacement. Before considering surgery, we explore other options like medication, steroid injections, activity modification and physical therapy.

When conservative measures are not helping, then we consider surgical treatment. Surgical treatment includes a total shoulder arthroplasty (shoulder replacement) or a reverse total shoulder arthroplasty. The difference between these two surgeries involves the ball and socket. When a patient has arthritis of the shoulder joint with a rotator cuff that is intact and functioning well, we can do a standard shoulder replacement. For this type of surgery, we attach a small shallow plastic socket to the worn-out socket. We remove the worn-out ball and replace it with a new metal ball attached to a stem. This new ball and socket joint is still unstable, so we rely on the functioning rotator cuff to provide stability, just like a healthy shoulder. This allows for a nearly normal, pain-free range of motion and strength.

Arthritis

We cannot do a standard shoulder replacement when a patient has arthritis combined with a large irreparable rotator cuff tear. In these cases, we do a reverse total shoulder replacement. This surgery involves attaching a ball to the worn-out socket and removing the worn-out ball, then replacing it with a deeper socket. This replacement creates a more stable ball and socket joint. It also allows the ball to become the fulcrum so the arm can rotate. It alleviates pain and improves function. The trade-off with a reverse total shoulder replacement is reduced range of motion. Therefore, we do this surgery only when the rotator cuff is not functional or repairable.

The surgery usually takes a little over an hour, so most patients spend one night in the hospital and are discharged the next day. Recovery involves six weeks of physical therapy. The patient has to wear a sling during recovery. Following this initial period of immobilization, we progress to active range of motion, then strength conditioning. Total recovery time is approximately 4-6 months. Most patients feel their pain is improved within a few days to weeks.

About the author

Dr. Robertson is an expert in shoulder replacement.

Ben Robertson, MD

Ben Robertson, M.D. is an orthopedic surgeon at Tri-County Health Care serving patients in Wadena and Baxter. He attended medical school at the Medical College of Wisconsin and completed his residency at the University of Minnesota. Additionally, he also completed a sports medicine fellowship in Oslo, Norway. He specializes in sports injuries, knee ligament reconstruction, and shoulder, hip, and knee replacement. Outside of work, Dr. Robertson enjoys bicycling, reading and spending time with his wife and three children.


The 500th joint replacement

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Tri-County Health Care recently celebrated the 500th joint replacement.

In the winter of 2021, Tri-County Health Care’s orthopedics team hit 500 joint replacement surgeries. Sometimes people get obsessed with statistics without thinking about what the numbers represent. In this case, 500 joints have been effectively replaced, meaning hundreds of people are free from chronic pain and even immobility. Dozens of people can play with their grandchildren once again, mow the lawn, go shopping, or just live life. Carla Schwantz is our 500th joint replacement recipient. Her story is special and serves as an excellent breakdown of the patient experience at Tri-County Health Care.

2021-The beginning

Carla Schwantz

Carla Schwantz

Carla is an active lady; she loves bike riding and enjoying the outdoors. Family means a lot to her, but pain has crept into her life in recent years. In 2021, this pain became too much to bear, so she decided it was time to do something about it.

June 9, 2021-First meeting

Early in the summer of 2021, Carla met with Ben Robertson, M.D. to discuss the pain. The pair decided that hip replacement surgery was necessary.

July 6, 2021-Thinking of the future

Carla’s case is unique. She was enduring multiple sources of joint pain. While dealing with her hip pain, Dr. Robertson found that Carla could also benefit from bi-lateral knee replacement. That surgery was scheduled for December 6, 2021.

August 23, 2021-Surgery

Carla and Dr. Robertson discussing the procedure.

Carla had hip surgery toward the end of summer. Carla also went through a physical therapy regimen in the fall. She often commented on the lack of pain she experienced post-surgery.

December 6, 2021-Knee surgery

Finally, the big day arrived. Carla underwent her second surgery. After some prep time, Dr. Robertson signed her knees, and she was off to surgery. Everything went as planned.

December 10, 2021-Therapy

This time around, physical therapy was more intense. Carla worked to restore range of motion and learned how to walk again. Typically, a recipient of this type of surgery usually has to go through 12 therapy sessions.

The future

Carla is recovery well after her surgery.

Carla is doing well and is nearing the end of her physical therapy. It takes around six weeks of recovery time, but patients will have to focus on at-home exercise for months after.

Tri-County Health Care would like to congratulate the orthopedics team and Carla on the 500th joint replacement. For more information about orthopedics and take a free joint health assessment, please visit TCHC.org/firststep. Call 218-631-3510 for scheduling.


Honesty and Healthcare: A letter from Joanne Flom

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Going to the hospital or clinic can be anxiety-inducing, especially as we get older. The knees start to get a little sore, our bones creak and crack, things just don’t work as well as they used to. This realization keeps many from visiting the doctor’s office. However, old age didn’t stop Joanne Flom from seeking help. She looks for honesty and good care and she found it close to home.

Knee pain is a common issue faced by many seniors

Royal treatment

Joanne is 81 and frequently experiences issues associated with old age. Many seniors simply learn to live with medical issues and chronic pain, but not Joanne, she doesn’t need to. She found Ben Robertson, M.D. who has played a pivotal role in her health and wellbeing.

Dr. Robertson is an orthopedic surgeon with Tri Orthopedics and is well known across the region for his expertise in everything involving muscles, joints and bones. During a presentation by Dr. Robertson, he suggested Joanne try a new kind of shoes to help with the pain. It was a simple solution but it turned out to be a pain-relieving miracle. Ever since then, she has met with Dr. Robertson for her all her orthopedic needs.

In a special letter sent to Tri-County Health Care, Joanne expressed her gratitude for all staff members involved in her recent appointment.

“This is the second time I’ve come to Wadena to see him. My treatment yesterday was perfect. I had to wait several days to see him but when the day finally arrived, I was treated like a queen.”

No more pain

Joanne had been suffering from some fairly intense knee pain. After her arrival, it was evident that she was struggling to make her way to the entrance of the clinic. Joanne was swiftly assisted by a patient escort. He got her a wheelchair and made polite conversation all the way to her appointment.

The appointment went swimmingly. Dr. Robertson and his staff politely conducted the examination with poise and speed. After examining her knees and x-rays, Joanne received two shots and was on her way.

Within a day, Joanne’s swollen knees were feeling much better. She had been in so much pain that she was unable to sleep. One of her knees was so inflamed that it had swollen several inches. After her consultation and injections, the swelling was gone and she slept ten hours straight!

Legacy of great care

“I would recommend your staff to anyone in need, I’ve had a good number of dealings with your staff. Other members of my family have had good experiences. They were all handled perfectly. The honesty is wonderful and the care is good,” Joanne explained in her letter. To Joanne, honesty is the most important aspect of care.

Dr. Robertson and his staff really enjoy helping seniors

Joanne has a storied history with Tri-County Health Care. Every family member that has passed through the clinic or hospital has recognized the top-notch focused care. Her father had been hospitalized for two months and she recalled him also feeling like royalty throughout his stay.

Joanne wanted to spread her message far and wide about Tri-County Health Care. She ended her letter by simply thanking Dr. Robertson and all members of staff for making her visit extra special.

Whether you’re feeling day-to-day aches and pains or experience serious issues, the Tri Orthopedics team is available to serve you. Please call 218-631-3510 to schedule an appointment.


Treating arthritis: ‘I got so much relief from my pain’

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Joint pain can be debilitating. It can interrupt your daily life and keep you from doing what you love. Arthritis is one of the most common causes of joint pain in the U.S., affecting more than 50 million people. There are many types of arthritis, but at its core, it refers to joint pain or joint disease. Symptoms can range from mild to severe and include pain, swelling, stiffness and reduced Arthritis patient, Jean Wallgren, smiling and sitting next to orthopedic surgeon Ben Robertson.range of motion.

Having a joint replacement is one of the solutions to severe arthritis. Jean Wallgren of New York Mills recently found herself facing this decision after many years of suffering.

 

Finally finding relief

Jean first noticed her joint pain back in 2011. At the time, she was told it was her knee and tried several treatments that did little to curb the discomfort. Life soon became busy, so she ignored it.

When her husband was diagnosed with astrocytoma – a brain tumor – in 2015, her health took even more of a back seat. He passed away on Sept. 6, 2016, and Jean was left to carry a full load of responsibilities. Her joint pain became so severe that she could barely walk around her house.

“For the last, I would say, two months, even my sleep was affected,” she said. “I couldn’t sleep lying in bed because it put so much pressure on it. And I tried to sleep in a chair, but that would only work for a couple hours.

“One day, my son, whose wife works at Wadena, came over and he said, ‘OK, that is it. Either you go to the doctor or I’m bringing you.’”

Jean had heard that Ben Robertson, M.D., recently spearheaded an orthopedics program in Wadena, and after doing extensive research, she determined Tri Orthopedics was the right option for her.

“So I made an appointment thinking it was my knee,” she said. “When he got the X-rays and he came into the room, he said, ‘We have to replace the right hip.’ I said, ‘No, I’m here for the right knee.’ I mean, I just hadn’t even thought of that. I thought it was the knee. Well, the knee isn’t great either, but I think the hip was so bad that it put everything else off balance.”Illustration showing the arthritis of the hip joint on a white background

One of the reasons Jean chose Dr. Robertson was his expertise in performing direct anterior hip replacements. This means that he operates through the front of the hip rather than the back. This causes less damage to major muscles, which quickens recovery time and lessens pain after surgery.

“Some of my friends who have had this [traditional hip replacement] done before have this big incision on the back side, and it takes as long for that to heal as it does for the hip,” Jean said. “I just had this little four-inch incision.”

Dr. Robertson replaced Jean’s hip on Nov. 7, 2018.

 

Regaining her independence

Because of the efficiency of the anterior approach, Jean only stayed for one night in the hospital before going home. Other than the initial discomfort caused by the surgery, she said her pain was soon gone.

“I did take one pain pill after I got home, but then that was the end of it,” she said. “It hurt less after the surgery than it did before. My pain from my joint was so bad before that after I got it replaced, I would say within even a week’s time, the pain had just disappeared.”

By the two-week mark, she was able to walk without a cane and soon had her driving privileges reinstated.

“I got so much relief from my pain,” she said. “I can move, go for a walk and I can ride my bike. I’ve been down to the garden.”

X-ray of a new Arthroplasty of the hip joint. (Abbreviation: HTP or H-TEP) from 2009Jean’s eight grandchildren are an incredibly important part of her life, and her hip replacement has allowed her to interact with them like she used to before the pain took hold.

“One of the last times I was there before I had this hip, I could hardly even get on the floor to play with them,” she said. “And carrying them up the stairs, I could hardly do it. I was just in so much pain. Now I go there, and I can get on the floor and give them a bath. It’s so nice to have that independence back.”

 

It takes a team

“One thing I think that is good is that team effort. They coordinate well with each other,” Jean said of the staff that cared for her. “You meet with the doctor, then physical therapy is involved. There are a lot of really nice nurses here. Wadena is really fortunate in that. They just all seem like they’re concerned about the patients and very polite. The staff here is really nice, really good. And just really caring. I get the feeling that they are so dedicated to their jobs. I think they really admire Dr. Robertson too, so that’s important.”

Jean praised Dr. Robertson’s attention to detail and his dedication to contamination and infection control. She described him and the orthopedics program as being strong assets for the hospital as well as the community as a whole.

“I think the biggest thing I want to impress is that Dr. Robertson is just so kind and so thorough in the examinations,” she said. “And the way the surgery went. I got here that morning, and everything was all set and I got taken back quickly. And before you know it, it’s all done. It was just a wonderful experience. I just can’t say enough good things.”

 

For more information about Tri Orthopedics, call 218-631-3510 or click here.

 

If you have a story to share about your experience with Tri-County Health Care, please tell us about it here.


Full orthopedic services, total joints come to Wadena

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Total joint replacements, fracture care, ACL reconstruction – all this and more are now offered full time at Tri-County Health Care through its new Tri Orthopedics program. The service was made complete with the transition of orthopedic surgeon Ben Robertson, M.D., from a visiting specialist to a full-time provider.

Most notably, the lineup of services includes total joint replacements, which remove a damaged or arthritic joint and swap it with a prosthetic device designed to move and function like that of a healthy joint. This is a reliable option for when physical therapy, medication or life modifications don’t help. Dr. Robertson has special training in direct anterior hip, Oxford knee and reverse total shoulder replacements.

Other orthopedic services offered include:Dr. Robertson, orthopedic surgeon

  • Carpal tunnel release
  • Ganglion cyst removal
  • Bunion and hammertoe corrections
  • Rotator cuff repair
  • ACL reconstruction
  • Arthroscopy procedures
  • Fracture care
  • Osteoarthritis care
  • Repetitive use/sports injuries

Getting her life back

Junelle Jackson of Wadena loves being outside, push mowing the lawn, and running around with her grandsons. She recently retired after 35 years of teaching at Wadena-Deer Creek, with 15 of those spent in kindergarten and 20 in second grade. But several years ago in 2012, she could barely function in everyday life, much less keep up with her students, because of intense pain in her knees.

“I’m not a person to just sit. I think that was the hardest when my knees hurt,” she said. “I found myself coming home from school and just sitting until it’s time to go to bed. And that’s not me. I just lost my life.”

It turns out Junelle suffered from arthritis in both knees, which progressed to bone rubbing against bone. She knew her mother and aunt had sought Dr. Robertson for knee replacements, and she witnessed the new life it gave them, so she decided to see him too.

Dr. Robertson tried cortisone injections and other options first to prolong surgery as much as possible, but it soon got to the point where nothing could take the pain away.

He determined it was time and recommended replacing both knees simultaneously. So she did.

Junelle Jackson, orthopedic services patient.“It was amazing. The pain from the surgery was less than the pain I was suffering every single day. It was a no-brainer to go,” she said. “It was on June 5, and I was back in school by the end of August. At the time, I was teaching kindergarten. I was able to get back on the floor. We were singing, dancing like you do in kindergarten. I was like a brand-new person.”

In 2016, her right hip began to exhibit the same painful symptoms her knees once had. She said there was “absolutely no question” in going back to Dr. Robertson. He performed a hip replacement in June, and by August, she was strolling about the Minnesota State Fair and taking her dogs for much-loved walks.

“Before I had my knees done or my hip, there was no way I could make it down the street and back,” she said. “Life is just awesome now.”

 

‘It’s going to be amazing in Wadena’

Over the years, because of the success Junelle’s had with Dr. Robertson, she has sent countless people his way. Anytime a friend or family member complains of severe joint pain, she’s there with a glowing recommendation.

“There’s no question in my mind,” she said. “Dr. Robertson is just amazing. He won’t rush into the surgery. He tried everything he could to get the pain to go away. He’s always smiling. He always greets you by name. He never forgets who you are. He’s just so kind, patient. You’re so comfortable with him.”

Junelle also worked closely with the joint care coordinator, Medley Shamp, RN. She praised Medley’s kind heart and diligence in her care. “She is just a honey,” Junelle said. “We just held each other and cried because she knew what I was feeling. She becomes an instant friend.” Then she expressed gratitude for the entire team and added, “I love everybody that’s here.”

Junelle’s surgeries and daily joint camps took place in Brainerd where Dr. Robertson practiced at the time. Though she absolutely loved her experience there, she noted that the 45-minute drive was inconvenient. So when she heard that total joints and orthopedics were coming to Wadena, she was ecstatic.

“At first, I didn’t believe it. I just thought it was too good to be true,” she said.

“But I just think it is the best thing that Tri-County could do is to get him here, to get his staff, that orthopedics is all right here in town. It’s going to be amazing in Wadena.

“We had to have a coach for joint camp, and it was hard for me to get a coach because they had to drive every single day. But now being here in town, your coaches are available, your rehab, your hospitalization, your after appointments. Like I said, I was amazed. It’s the best thing they could have ever done.”

 

If you’re experiencing joint or muscle pain, don’t wait any longer. Dr. Robertson and Tri Orthopedics can help take it away and return you to the life you love.

To learn more, visit TCHC.org/ortho or call 218-631-3510.