Private Orthopaedic Surgery

Reverse Shoulder Replacements

Reverse shoulder replacement, also known as reverse total shoulder arthroplasty (RTSA), is a surgical procedure used to treat certain shoulder conditions, particularly those involving irreparable rotator cuff tears or severe arthritis combined with rotator cuff dysfunction.

In a traditional shoulder replacement, a plastic socket is used to replace the damaged shoulder joint’s ball, while a metal ball is implanted into the humerus (upper arm bone). This type of replacement relies on the rotator cuff muscles to function properly to move the arm.

In contrast, a reverse shoulder replacement switches the ball-and-socket orientation. A metal ball is attached to the shoulder socket, and a plastic socket is placed on the upper end of the humerus. This design allows the deltoid muscle, instead of the damaged rotator cuff muscles, to take over and move the arm. As a result, the procedure can be beneficial for patients with severe rotator cuff tears because it relies on a different set of muscles for arm movement.

Candidates for reverse shoulder replacement typically include those with:

  1. Irreparable rotator cuff tears: When the tendons of the rotator cuff are severely damaged or torn and cannot be repaired.

  2. Cuff tear arthropathy: A condition where long-standing rotator cuff tears lead to shoulder joint degeneration and arthritis.

  3. Failed previous shoulder surgeries: Patients who have undergone previous shoulder surgeries without improvement or with complications may be considered for this procedure.

The reverse shoulder replacement procedure can provide pain relief and improved shoulder function for patients who were previously suffering from severe shoulder pain and loss of mobility. As with any surgery, it carries potential risks and complications, and patients should have a thorough evaluation with their orthopedic surgeon to determine if it is the best treatment option for their specific condition. Post-surgery, patients will need to undergo physical therapy and rehabilitation to regain strength and range of motion in the shoulder.

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Total Shoulder Replacement FAQs

Total shoulder replacement, also known as total shoulder arthroplasty, is a surgical procedure in which the damaged parts of the shoulder joint are replaced with artificial components. The procedure is performed to relieve pain and improve function in patients with severe shoulder joint damage due to conditions like osteoarthritis, rheumatoid arthritis, or traumatic injury.

The duration of total shoulder replacement surgery can vary, but typically it takes around two to three hours to complete. However, the actual time may depend on various factors, including the complexity of the case and the surgeon’s experience.

The artificial components used in a total shoulder replacement consist of a metal ball (made of cobalt-chrome) that replaces the humeral head (upper arm bone), and a plastic socket (made of high-density polyethylene) that replaces the glenoid cavity (shoulder socket).

After surgery, you will spend some time in the hospital for monitoring and initial recovery. Physical therapy is an essential part of the rehabilitation process and usually begins soon after surgery. You will need to wear a sling for a few weeks to support the shoulder and protect the surgical site. Full recovery can take several months, and during this time, you will gradually regain strength and range of motion in your shoulder.

Like any surgical procedure, total shoulder replacement carries some risks, including infection, bleeding, blood clots, nerve damage, implant loosening, dislocation, and stiffness. Your surgeon will discuss these risks with you and take appropriate measures to minimize them.

The lifespan of a total shoulder replacement can vary among individuals. On average, a well-functioning shoulder replacement can last 15 to 20 years or more. However, the longevity of the implant depends on factors such as age, activity level, and overall health.

Yes, most patients can resume normal daily activities after a full recovery from total shoulder replacement. However, high-impact or repetitive activities, such as heavy lifting or contact sports, may need to be avoided to prevent excessive stress on the artificial joint. Your surgeon or physical therapist will provide specific guidelines regarding activities and restrictions.

In some cases, alternative treatments may be considered before opting for total shoulder replacement. These alternatives can include conservative measures like medications, physical therapy, cortisone injections, or arthroscopic surgery. The most appropriate treatment option will depend on the specific condition and its severity.