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PAT I E N T E D U C AT I O N
TO R N I E R
AEQUALIS ASCEND FLEX
Convertible Shoulder System
Causes of Shoulder Pain
Did you know the shoulder is the most mobile joint
in the body?
The shoulder isn’t just one structure alone, it is made
up of tendons, ligaments, muscles and bones that all
work together to allow us the freedom of movement.
With the wide range of movement and multiple
structures, the shoulder is frequently subject to
injury or damage.
Some conditions that can cause your shoulder joint to be painful or
have limited movement include osteoarthritis, torn or damaged
rotator cuff, fracture, shoulder dislocation, frozen shoulder,
rheumatoid arthritis, and other conditions. Your surgeon
can diagnose and offer options for addressing your
specific condition.
For some conditions, your surgeon may recommend
a shoulder joint replacement for you. Shoulder joint
replacement can be an effective solution for patients
experiencing arthritis and/or rotator cuff disease.
This educational piece will describe specific types of
shoulder implants that may be used for restoring
function and addressing pain.
Shoulder Anatomy and Function
Bony Anatomy Overview
Chiefly important among the bones that make up your shoulder are
the humerus (arm bone) and the scapula. The humeral head (or “ball”)
articulates against the socket of the scapula, referred to as the “glenoid,”
during movement. Cartilage is present between the humeral head and
glenoid in healthy shoulders, which is a tissue that acts as a cushion
between the two bones and allows for pain-free movement of the joint.
clavicle
humeral head
(ball)
humerus
glenoid
(socket)
scapula
Normal Shoulder Anatomy
Rotator Cuff Overview
The rotator cuff is a group of four muscles that surround the shoulder joint,
providing needed stability for full arm motion. When any one of the rotator
cuff structures are not functioning properly due to injury or degradation
of muscle tissue common with the aging process, your mobility can be
compromised and you can experience minor to significant pain.
infraspinatus
muscle
supraspinatus
muscle
subscapularis
muscle
Anterior (front view)
teres minor
muscle
Posterior (rear view)
Shoulder Replacement Options
You and your surgeon will discuss what the best
option is for you, and that may include a total
shoulder replacement. There are two types of
shoulder replacements - primary total shoulder
replacement and reversed total shoulder
replacement. Some of the topics you and your
surgeon may discuss to determine if a shoulder
replacement is the right option for you include,
but are not limited to:
• Current function of your rotator cuff
• Your age
• Your activity level and everyday
living expectations
Primary Total Shoulder
Patients with bone-on-bone osteoarthritis
(where cartilage between the humerus and
glenoid is gone) and who have a healthy,
intact rotator cuff may be candidates for
primary total shoulder replacement. With
a primary total shoulder replacement, the
humeral head (ball) of the shoulder joint is
replaced with an implant that includes a stem
with a smooth, rounded metal head. The
glenoid (socket) is replaced with a smooth,
curved plastic component that fits the head
of the ball. The result is a prosthetic humeral
head that articulates on the glenoid implant
when moving your arm, which eliminates
bone-on-bone contact that caused pain and
compromised range of movement.
humeral
head
component
humeral
stem
component
glenoid (socket)
component
Reversed Total Shoulder
Patients with bone-on-bone osteoarthritis
and an unhealthy, compromised rotator
cuff may be candidates for a reversed total
shoulder replacement. With a reversed
total shoulder replacement, the normal
structure of the shoulder is “reversed.” The
ball portion of the implant is attached to the
glenoid (where the socket normally is) and
the artificial socket is attached to the humerus
(where the ball normally is). The reversed
procedure can be a consideration when the
rotator cuff is severely damaged and cannot
be repaired. Like the primary total shoulder
replacement, pain and function may be
restored with the use of prosthetic devices.
humeral
socket
component
humeral
stem
component
* Your surgeon will discuss your specific condition and explain the potential
benefits, risk and considerations of any surgical or non-surgical treatment
option to manage your shoulder condition.
glenoid (ball)
component
Offering Options and
Peace of Mind
Although shoulder devices are documented to last beyond ten years,
the length of time your device lasts is highly dependent on many
factors including your age, weight, activity level, sustained injury,
healing rate, infection, rotator cuff function, overall health, and other
factors. Total shoulder arthroplasty has a 91% survivorship at 10 years
and complications are rare.1 However, natural thinning of the rotator
cuff muscles and potential falls may lead to the need to exchange the
total shoulder to a reversed shoulder.
New advances in total shoulder implants allow for more flexibility
from a primary to a reverse shoulder replacement. The AEQUALIS
ASCEND™ FLEX Convertible Shoulder System gives your surgeon the
options needed to improve current shoulder function while addressing
potential future considerations.
Flexibility in Action
Should a conversion from a Primary Total Shoulder to a Reversed Total
Shoulder be required, traditional shoulder systems often require stem
removal, which can potentially lead to increased blood loss, bone loss,
OR and anesthesia time. With the AEQUALIS ASCEND™ FLEX system,
conversion is often a simple exchange of components on top of the stem.
1. Remove humeral head & glenoid socket component
2. Place humeral socket & glenoid ball component
This pamphlet contains general medical information and
does not replace the medical advice of your physician. If you
have questions about your medical condition or exercises,
ask your doctor or health care provider.
For more information and to find a shoulder
surgeon near you, please visit:
www.liftmyarm.com
References
1. J.A. Singh, MBBS, MPH, J.W. Sperling, MD, et al, Revision surgery following
total shoulder arthroplasty, Journal of Bone & Joint Surgery, Nov 2011, vol
93-B no. 11 1513-1517.
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CAW-7584 rev B ECN 160414 24-Feb-2016