Reverse Total Shoulder Replacement

Reverse total shoulder replacement is a specialized surgical procedure aimed at replacing damaged components of the shoulder with artificial ones. The shoulder joint, comprising the upper arm bone (humerus) and the shoulder blade (scapula), facilitates a wide range of motion. However, damage to this joint can result in pain, weakness, and stiffness.

During the surgery, the surgeon removes the rounded head of the upper arm bone and affixes a plastic socket to the remaining bone using screws and specialized tools. Additionally, a portion of the socket of the shoulder blade is substituted with a metal ball, allowing it to move within the socket attached to the upper arm bone. This differs from standard total shoulder replacement, where the metal ball attaches to the upper part of the humerus and the new socket attaches to the shoulder blade, more closely resembling the natural anatomy.

Reverse total shoulder replacements are recommended by healthcare providers for specific shoulder injuries, particularly those involving arthritis with a large rotator cuff tear. The surgery may be recommended if severe pain and weakness in the shoulder significantly impede daily activities, and if symptoms persist despite other treatments like medication, injections, and physical therapy.

While most individuals undergo standard total shoulder replacement, reverse total shoulder replacement is preferred for certain injuries like extensive rotator cuff tears, as it often provides improved pain relief and mobility. Instead of relying on the rotator cuff, the deltoid muscle is utilized to lift the arm after surgery.

Risks associated with this surgery include infection, excessive blood loss, nerve damage, bone fracture, dislocation of the artificial joint, and complications from anesthesia. These risks may vary based on individual factors such as the nature of the shoulder problem and overall health.

Preparing for the surgery entails discussing medications with your provider, including over-the-counter drugs and supplements, and adhering to specific instructions regarding medication cessation and fasting before the procedure.

Imaging tests such as X-rays, CT scans, or MRIs may be performed before surgery to thoroughly evaluate the shoulder’s condition.

During the procedure, which typically lasts several hours, the surgeon removes the damaged sections of the humerus and scapula, attaching the metal ball to the scapula and the plastic socket to the upper arm bone using screws.

Following surgery, patients may initially experience numbness, pain, and restricted movement. Physical therapy, continued icing, and adherence to provider instructions for wound care and rehabilitation are crucial for recovery. Most patients can resume light work within a few weeks, with follow-up appointments scheduled to monitor progress.