Unique surgery turns reaching forpain relief

DELILA REILE of Fargo (right) has had total joint replacement on both shoulders. DR. PRASAD SAWARDEKER, an Essentia Health orthopedic surgeon, did her latest surgery using reverse total shoulder replacement, which was developed for patients like Reile who have a damaged rotator cuff and a degenerative type of arthritis called cuff tear arthropathy.

Delila Reile spent decades working on her family’s farm near McClusky, North Dakota, and painting houses. The work took a heavy toll on her shoulders so she’s chosen to have total shoulder replacement surgery twice.

Now 83 and living in Fargo, Delila turned to Dr. Prasad Sawardeker, an Essentia Health orthopedic surgeon, for her latest surgery.

Persistent pain and a weakening shoulder had first brought Reile to Dr. Daniel Ostlie and Physician Assistant Ryan Kessel in Essentia Health’s Orthopedics and Sports Medicine Department at the 32nd Avenue Clinic in Fargo. They were able to provide some relief with injections and physical therapy but when she couldn’t get lasting relief, Reile turned to Sawardeker, who specializes in shoulder, elbow and hand surgery.

The experienced orthopedic surgeon recommended reverse total shoulder replacement, which would take away Reile’s painful arthritis and improve her strength and range of motion. She had had some success with her right shoulder surgery in 2016, so she decided to go ahead with the left. “I said, ‘Let’s do it. If it works, it works,’” Delila recalls.

During surgery, Sawardeker reversed two key parts of the shoulder joint. He attached an artificial socket to the top of her arm bone and fixed a metal ball into her shoulder blade. This technique was developed for patients like Reile who have a damaged rotator cuff and a degenerative type of arthritis called cuff tear arthropathy.

In a healthy shoulder, rotator cuff muscles provide proper motion, function and stability. Conventional replacement surgery still relies on these muscles, which no longer function in a patient like Reile. Reverse replacement instead relies on the deltoid muscle on the top of the shoulder, Sawardeker explains.

Reile’s shoulder motion had become very limited. She could only reach to shoulder level in front and could not reach above her head at all. She had extreme weakness in her shoulder and muscles were atrophying. She couldn’t sleep and struggled with daily tasks, like getting dressed and cooking meals. “I couldn’t lift, and cooking — I just couldn’t do it,” Reile recalls.

Reile, who retired at age 70, says hard work wore out her shoulders. “Heavy labor and wear and tear certainly contribute to the overall degenerative process that occurs in patients with arthritis,” Sawardeker says. “The pain was quite debilitating for Delila.”

After a successful surgery and an overnight stay at Essentia Health Fargo, Reile recovered at home and even received her physical therapy there. At her one-year follow-up appointment, she had no pain and a full range of motion in her left shoulder and arm.

“Many patients find their pain is markedly improved after surgery,” Sawardeker says. “Most can reach to shoulder level by six weeks and regain the ability to lift overhead by 12 weeks. Most patients are satisfied with their outcome in the first three months and final results are usually achieved within a year.”

Reile appreciates not only the care she received from Sawardeker but also his willingness to answer her questions and spend time with her. “He’s a very good doctor,” she says.

“Communicating with my patients is one of the most important parts of my job,” Sawardeker says. “I carefully go through the risks and benefits of a surgery and we make an informed decision together. I want to make them feel secure and comfortable with their decision to proceed with replacement surgery.”

Make An Appointment

Dr. Prasad Sawardeker is chair of the Orthopedics and Sports Medicine team at the Essentia Health – 32nd Avenue Clinic in Fargo. He specializes in shoulder, elbow and hand surgeries.

Dr. Sawardeker is board certified by the American Board of Orthopedics and was recently inducted into the American Society of Shoulder and Elbow Surgeons, which is made up of leading national and international orthopedic surgeons.

To make an appointment, call 701-364-8900.

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