The Reverse Shoulder Replacement is an exciting breakthrough in shoulder surgery. It is a new treatment option for patients who have suffered with shoulder arthritis and rotator cuff dysfunction. Until now, there were limited surgical options for patients with this combination of problems. Patients were offered procedures that were unreliable in achieving and maintaining pain relief and functional improvements. The Reverse Shoulder Replacement has been used successfully in Europe for over 10 years, and has recently been approved for use in the United States.
What is a Reverse Shoulder Replacement?
The Reverse Shoulder Replacement differs from a traditional Total Shoulder Replacement in that the ball and socket are reversed. The ball (glenosphere) is placed onto the glenoid (socket), and the socket is placed on the ball (humerus). The Reverse Shoulder Replacement provides the additional shoulder stability needed when the rotator cuff is not functional. Once the shoulder regains stability, improvements are seen in both pain relief and shoulder function.
When is the Reverse Shoulder Replacement used?
The rotator cuff is a key stabilizer of the shoulder. Patients may have severe loss of rotator cuff function from massive rotator cuff tear, previous surgery, or a previous fracture. In many of these cases, shoulder arthritis develops. Once the combination of irreparable rotator cuff dysfunction and arthritis is present, the Reverse Shoulder Replacement can be considered. This procedure can also be used in revision surgery, after failed shoulder replacement and shoulder fractures.
What are the benefits of a Reverse Shoulder Replacement?
If the rotator cuff is functioning properly, you do not need a Reverse Shoulder Replacement. Your function will be much better with a Total Shoulder Replacement, as normal anatomy is reconstructed. The Reverse Shoulder Replacement is used only when the rotator cuff cannot be reconstructed.
Dramatic improvements have been seen in pain relief, range of motion, and ability to perform daily activities (ie, eating, drinking, grooming). The return of independence is probably the key benefit that patients experience, as they are able to regain function and use of the arm.
How long does the surgery take?
The surgery is done using a general anesthetic and typically takes approximately 2 hours.
What is the recovery process?
The recovery is similar to the recovery after a traditional Total Shoulder Replacement. You will be immobilized for a period of 6 to 8 weeks to allow for healing. Then you will begin a progressive therapy program that emphasizes stretching followed by strengthening.