Reverse shoulder replacement

Reverse Shoulder Replacement is a type of shoulder arthroplasty that involves a surgical procedure to replace the damaged parts of the shoulder joint with artificial components. This procedure is called "reverse" because it swaps the natural positions of the shoulder's ball and socket. Unlike traditional shoulder replacement surgery, where the artificial ball is attached to the shoulder bone and the socket is placed in the shoulder blade, reverse shoulder replacement attaches the artificial ball to the shoulder blade and the socket to the upper part of the arm bone. This design is particularly beneficial for patients with complex shoulder conditions, such as cuff tear arthropathy, a condition where severe rotator cuff tears have led to arthritis of the shoulder, or for those who have had previous unsuccessful shoulder surgeries.

Indications

Reverse shoulder replacement is indicated for individuals with:

• Severe shoulder arthritis combined with a large rotator cuff tear.
• A previously failed shoulder replacement.
• Complex fractures of the shoulder joint.
• Severe shoulder pain and difficulty lifting the arm away from the side or overhead, which significantly affects daily activities.
• Cuff tear arthropathy.
• Massive, irreparable rotator cuff tears without arthritis.

Procedure

The surgery is performed under general anesthesia. The surgeon makes an incision over the shoulder to expose the shoulder joint. The damaged bone and cartilage are removed, and the positions of the shoulder's ball and socket are reversed in their placement. The artificial socket is attached to the upper part of the humerus (arm bone), and the artificial ball is attached to the shoulder blade. This configuration allows the deltoid muscle, rather than the damaged rotator cuff, to lift the arm.

Recovery

Post-surgery, patients typically wear a sling for 4 to 6 weeks and undergo physical therapy to regain movement and strength. Full recovery and maximum benefit from the surgery may take several months. The success of the surgery largely depends on the patient's adherence to the rehabilitation protocol.

Risks and Complications

As with any major surgery, reverse shoulder replacement carries risks, including infection, nerve injury, and dislocation of the artificial components. However, the incidence of these complications is relatively low.

Benefits

The primary benefit of reverse shoulder replacement is the significant reduction in shoulder pain and improvement in arm function, especially in lifting the arm overhead. This surgery allows patients who have had little to no shoulder function due to complex conditions to regain significant function and quality of life.