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Reverse Shoulder Replacement

Shoulder pain can significantly impact your quality of life, limiting your ability to perform everyday tasks or engage in physical activities. For those suffering from severe shoulder conditions, a reverse shoulder replacement offers a promising solution. 

At Precision Orthopaedic Specialties, located in Chardon, Chagrin Falls, and Middlefield, Ohio, we provide expert care tailored to each patient’s unique needs. Contact us today to schedule a consultation! 

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What is a Reverse Total Shoulder Replacement?

A reverse total shoulder replacement is a specialized form of shoulder surgery designed to address severe shoulder dysfunction, particularly in cases where the rotator cuff tendons are damaged. 

Unlike traditional shoulder replacement surgery, this procedure reverses the anatomy of the shoulder joint: the ball is attached to the shoulder blade (scapula), and the socket is placed on the upper arm bone (humerus).

This innovative approach shifts the workload from the weakened rotator cuff muscles to the deltoid muscle, allowing for improved arm mobility and function, even when the rotator cuff is not functional.

A doctor examining a patient’s shoulder before revision replacement surgery in Chardon, Ohio.

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Who Can Benefit from This Procedure?

A reverse shoulder replacement is primarily recommended for patients who have:

  • Severe rotator cuff tears that are irreparable
  • Cuff tear arthropathy, a form of arthritis caused by long-standing rotator cuff damage
  • Advanced shoulder arthritis combined with significant rotator cuff injuries
  • Previous failed shoulder surgery or traditional total shoulder replacement
  • Complex fractures of the arm bone near the shoulder

This procedure is particularly beneficial for individuals experiencing chronic pain, loss of shoulder function, and those for whom other treatments have been ineffective. It is an excellent option for middle-aged and older adults, including athletes and active individuals who wish to regain their shoulder mobility and reduce pain.

How to Prepare for Reverse Total Shoulder Replacement

Proper preparation is essential for a successful reverse shoulder replacement. Here are key steps to prepare:

  1. Medical Evaluation: Your doctor will conduct a comprehensive evaluation, including physical exams and medical history, to ensure you’re a good candidate for the surgery.
  2. Imaging Tests: X-rays and MRI scans will be used to assess the condition of your shoulder joint and rotator cuff tendons.
  3. Physical Therapy: Pre-surgical physical therapy may be recommended to strengthen the muscles around your shoulder, helping to facilitate recovery after surgery.
  4. Medication Adjustments: You may need to stop certain medications, such as blood thinners, before surgery to reduce the risk of bleeding.
  5. Home Preparation: Arrange for help at home during the initial recovery period and prepare your living space to avoid activities that strain the shoulder.

What Happens During Reverse Total Shoulder Replacement?

The surgical procedure typically follows these steps:

  1. Anesthesia: You’ll be placed under general anesthesia to ensure comfort and pain relief during the surgery.
  2. Incision: The surgeon makes an incision over the affected shoulder to access the joint.
  3. Joint Modification: The damaged portions of the shoulder joint are removed. The ball component is fixed to the shoulder blade, while the socket is attached to the arm bone.
  4. Implantation: The new prosthetic components are fitted and secured, often with screws or bone cement, to ensure stability.
  5. Closure: The incision is carefully closed with sutures or staples, and a dressing is applied to protect the wound.
 

The surgery typically lasts between two to three hours, depending on the complexity of the case.

What Happens After a Reverse Total Shoulder Replacement?

After surgery, your recovery will begin in the hospital, where you will be monitored closely. Key points of post-surgery care include:

  • Hospital Stay: Most patients stay for one or two days following the procedure to ensure they are stable and to manage initial post-operative pain.
  • Pain Management: Pain control will be managed through medications, both oral and intravenous.
  • Physical Therapy Initiation: A physical therapist will introduce basic exercises to keep the new joint mobile and prevent stiffness.
  • Sling Usage: You’ll need to wear a sling for several weeks to protect the joint while it heals.

Possible Complications

As with any surgery, reverse total shoulder replacement carries potential risks, including:

  • Infection: There is a small risk of infection at the surgical site.
  • Dislocation: The prosthetic joint may dislocate, especially if precautions are not followed.
  • Nerve or Blood Vessel Injury: There’s a risk of damage to nearby nerves or blood vessels.
  • Implant Loosening: Over time, the prosthetic components may loosen, requiring further intervention.
 

Discussing these risks with your surgeon can help you understand how to mitigate them and ensure the best outcome.

Recovery and Rehabilitation

Recovery from a reverse shoulder replacement is a gradual process that involves several stages:

  1. Early Recovery: In the first few weeks, you’ll focus on controlling pain and initiating gentle mobility exercises with the help of a physical therapist. You should be able to dress yourself in a few days
  2. Physical Therapy: Ongoing physical therapy is essential for regaining strength and mobility. The therapy will focus on improving the range of motion and rebuilding strength in the shoulder and surrounding muscles.
  3. Return to Activities: Light activities may resume after six weeks, but full recovery and return to more demanding physical activities, including sports, typically take 6-12 months.
  4. Follow-Up Care: Regular follow-ups with your surgeon are critical to monitor healing and ensure the prosthesis is functioning correctly.

Regain Your Shoulder Function with Precision Orthopaedic Specialties

If you’re considering a reverse shoulder replacement, trust the skilled team at Precision Orthopaedic Specialties. Our dedicated specialists provide comprehensive care to help you achieve the best possible results and return to an active, pain-free lifestyle.

Contact one of our offices in Northeastern Ohio today to schedule an appointment! Let us help you on your path to recovery and enhanced mobility.

Medically reviewed by Laszlo S. Harmat, D.O.

  1. https://orthoinfo.aaos.org/en/treatment/reverse-total-shoulder-replacement
  2. https://pmc.ncbi.nlm.nih.gov/articles/PMC10686035/

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