Re-engineering evolution
At the age of 92, William Shatner has shattered his shoulder upon being thrown from his horse. It's bad enough that he reports his doctors are recommending a "reverse shoulder replacement."
Apparently some bright soul noticed that the arrangement of the ball and socket in the shoulder is a vestigial design that is not the strongest option for an upright biped with a three-dimensional range of motion. If the shoulder is really toast and has to be replaced, it makes more sense for the new joint to have the ball on the torso and the socket on the top of the armbone.
In the new configuration, the center of rotation is moved downward (inferiorly) and inward (medially). The deltoid muscle (the large muscle covering the shoulder) gains a longer lever arm and better mechanical advantage in lifting the arm, while bypassing the often ruined (and irreplaceable) rotator cuff. The ball acts as a mechanical stop to prevent the humerus from sliding upward, converting the deltoid's pull into rotation and elevation rather than just shear forces. This makes for better overhead motion.
For now, at least, the improvement wouldn't be worth the trauma for someone suffering from garden-variety rotator cuff or arthritic trouble. Maybe someday, though, aspiring major-league pitchers will opt for it as a prophylactic upgrade.
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6 comments:
Riding a horse at 92 is serious business. It's an act of courage just to get into the saddle at that age.
Exactly.
Would have been nice to see this option before I had to have my left shoulder replaced. Now, I'm not saying that my replacement isn't good, it's just that with the shape that my shoulder was in at the time made attaching the cup to a place with very little bone left perilous to success. Being able to modify that bone for the ball while putting the cup on the arm would have saved some anxiety regarding the eventual capabilities I could expect.
I hope Mr. Shatner's shoulder makes a full recovery - and at 92 that in and of itself would be a minor miracle. I hope that it leads to even more innovative ideas in joint replacements. Not that I have that many left to replace.... 0>;~}
As I understand it, with this new surgery you can't expect the full range of motion that you'd have with a healthy natural shoulder, but you get quite a lot of function back, perhaps more than could be expected when the shoulder has been badly enough damaged, and you get a somewhat reduced chance of re-injury. They can do a lot with an artificial joint, but when the surrounding rotator cuff tendons are really toast, having the deltoid muscle substitute in is a great help.
I guess that means it's not in the cards for young, healthy pitchers to want to pursue this as an elective surgery.
When I got a Type III shoulder separation--all three tendons forming the shoulder joint being torn completely through-- several years ago, I asked the ER doctor if my shoulder could be repaired. He said, sure, there were two ways to do it, and each way would be good for only five or so years.
One way was to staple the tendon ends back together; the other way would be to stitch them back together. He also said that with the cost of either surgery and their short duration, I needed to be throwing professionally before the surgery would be worth the cost.
Since my throwing at that age consisted of tossing a football with my wife or then toddler grandson, or threatening various NFL football teams with walking on as a QB to replace the team's abysmal QB, I eschewed the surgery.
The outcome for me is an increased likelihood of arthritis in that shoulder. I have a normal range of motion, the various muscles surrounding my shoulder hold everything in place and for ordinary activities, I have normal strength in that shoulder. I can't do many pushups with it, or pullups, or otherwise use my shoulder in heavy leverage--the muscles are too flexible--and I do have to be at greater pains to exercise those muscles with strength training (and those of my other shoulder for symmetry's sake), but that's not all bad in its own right.
The thing I worry about with the OP surgery is the same thing that made the $6M Man unrealistic: the uprated body parts were still anchored to ordinary body parts, parts that could not sustain the pressures and leverages his artificial parts could do. It seems to me that the so radically altered shoulder could lead to damage to the rest of the shoulder, or collar bone, upper arm, even extend down into the elbow.
The surgery may be worth it to restore utility from nearly none, but maybe not for many walks of life.
Eric Hines
I have found out that this turns out to be exaggeration. The age we live in, I guess. He is getting some shoulder work done apparently, but not for the reasons listed. https://x.com/WilliamShatner/status/2032260046776852749?s=20
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