Reverse Total Shoulder Replacement
A total shoulder replacement is not always the best option for patients with deep rotator cuff tears who have developed arthritis (referred to as cuff tear arthropathy). This traditional surgery can limit range of motion following the surgery and result in more pain with movement. A reverse shoulder replacement is often a better solution.
Dr. Tuvi Mendel, our board certified orthopaedic surgeon, performs reverse total shoulder replacement surgery for patients with a combination of severe shoulder arthritis and rotator cuff tears. This surgical technique is a technologically advanced alternative to the more traditional, most common procedure for shoulder arthritis, Total Shoulder Joint Replacement. During surgery, the ball and socket joint is replaced in reverse of your original shoulder joint. In other words, the “ball” area of your upper arm bone is replaced with a cup and the old “socket” area is replaced with a ball.
This design improves shoulder function for patients who no longer have a functional rotator cuff. This is because reversing the way the joint comes together changes which muscles are used to operate the arm. With a traditional total shoulder replacement, the rotator cuff muscles power the arm when it is lifted or otherwise moved. In the event the rotator cuff muscles are torn, weak, or damaged as a result of arthritis or another concern, they will be unable to provide the force to operate the arm. With a reverse total shoulder replacement, the deltoid and other muscles do the work that was once performed by the rotator cuff tissues.
Total Shoulder Joint Replacement Surgery
The traditional total shoulder replacement surgery involves removal of the damaged bone surrounding your shoulder joint. Once the damaged bone is removed, they are replaced with metal and plastic parts that mimic the original ball and socket joint. Most people are satisfied with their total shoulder joint replacement. However, as with any surgical procedure, complications may arise. The hardware may shift or loosen over time requiring a revision surgery.
Who is a good candidate for reverse total shoulder replacement?
While an excellent procedure for certain qualified candidates, reverse total shoulder replacement is not appropriate for everyone. This operation may be right for you if you have:
- A completely, irreparably torn rotator cuff
- Shoulder arthritis
- Had a previous shoulder replacement that proved unsuccessful
- Significant and debilitating shoulder pain that limits arm motion
- No noticeable improvement from using non-surgical treatment
What can I expect during the procedure?
Dr. Mendel is extensively trained in leading techniques for reverse total shoulder replacement, including minimally invasive arthroscopy. This procedure typically takes about two hours and is considered an outpatient surgery, although your experience may vary. An incision is most commonly made on the top or front of the shoulder (multiple small incisions are used in some cases). The damaged bone will be removed and the new artificial joint components will be placed into position.
How long will recovery take?
Every patient heals at his or her own unique rate, and you should give yourself enough time to recover fully to achieve the best possible outcome. While some discomfort is to be expected, we will provide prescription medication to manage your pain. Additionally, physical therapy may be recommended to help enhance recovery and improve strength, range of motion, and flexibility in your arm. You will likely need to take at least a week or two off from work or daily activities, potentially more. After a few weeks, you should be able to eat, dress, and perform normal hygiene habits on your own. We recommend avoiding strenuous exercise and extreme arm positions for the first four-to-six weeks, and you should not lift anything over about five pounds during the same period. Be especially careful getting in and out of chairs or bed to avoid putting forceful weight on the affected tissues.
For more information about reverse total shoulder replacement surgery, or to schedule a consultation with Dr. Mendel, please contact our practice today.