Thousands of people have shoulder replacement surgeries every year to treat pain and stiffness caused by injury, arthritis and a number of other conditions. While many people have a standard “anatomic” total shoulder arthroplasty, some people need a reverse total shoulder replacement.
Like with all other surgeries, there are pros and cons to consider. In this blog, you’ll learn why a surgeon may recommend a reverse shoulder replacement, the benefits and limitations of this procedure, who is a good candidate for this type of joint replacement, and much more.
What is a reverse total shoulder replacement?
There are two main types of shoulder replacements: a standard (anatomic) and a reverse. You probably have an idea about how a standard shoulder replacement works – the artificial joint is placed in the shoulder in the same place as the original joint. The metal ball attaches to the upper humerus, and the plastic socket attaches to the shoulder blade.
But there are times when the shoulder rotator cuff tendons are torn and damaged so severely that they can’t keep the shoulder joint in place. Additionally, it may be recommended in cases of severe bone destruction or shoulder fractures. In these circumstances, an orthopedic surgeon will attach the artificial ball to the shoulder blade and the artificial socket to the arm bone. This type of joint replacement surgery is called a reverse shoulder replacement because it flips the placement of the socket and the artificial joint.
The type of implant typically used for a reverse shoulder replacement contains two parts
The ball component of the artificial joint is typically made of metal while the socket component is usually metal with a plastic lining. Creating artificial joints of metal on plastic allows for the joint to move smoothly while still being very durable.
Pros of a reverse total shoulder replacement
There are many benefits to getting a reverse total shoulder replacement. The first, and possibly most important, is that it can significantly decrease shoulder pain. During the procedure, your surgeon will remove the damaged tissue from your shoulder and resurface worn out joints, providing pain relief.
Improved range of motion and better shoulder function are other major benefits of undergoing a reverse total shoulder replacement. With the damaged joint gone and an artificial one in its place, you’ll have an easier time moving your shoulder and arm.
Another benefit of a reverse shoulder replacement is it has a higher likelihood of success and better recovery for people who have a severely torn rotator cuff or severe arthritis. This type of shoulder replacement surgery was developed to help treat serious damage to the rotator cuff, and it’s recommended when a standard shoulder replacement surgery is unlikely to get the best results.
Limitations after a reverse shoulder replacement
A reverse shoulder replacement can be a life-changing surgery. It will help restore the function of your shoulder so you can move comfortably and confidently again. However, even with surgery your shoulder may not return to exactly the way it was before your injury.
Because of the placement of the artificial joint, you may have less strength when lifting things above your head and reduced ability to reach behind your back. Generally, a reverse replacement increases your motion and function, but the range of motion is less than a standard replacement provides.
In many cases, physical therapy is recommended for people after they’ve undergone shoulder replacement surgery. A physical therapist will use specialized exercises, manual therapy techniques and other strategies to help you regain as much strength and range of motion in your shoulder as possible.
What to expect from reverse shoulder replacement recovery
How long it takes you to recover from a reverse shoulder replacement depends on several factors, including the severity of your injury. While you prepare for reverse shoulder replacement surgery, your surgeon will talk with you about what to expect during your recovery.
In most cases, you can expect to go home on the day of surgery or the following day. Keep in mind that during the first several days after your joint replacement surgery, you won’t be able to move your arm, wrist or fingers much. You’ll also likely need to wear a removable sling for 4-6 weeks following the procedure. It takes time for the shoulder to heal.
Candidates for reverse shoulder replacement
When possible, people will get a standard shoulder replacement. This type of joint replacement relies on intact muscles and tendons in the shoulder. However, your surgeon might recommend a reverse total shoulder replacement if you have a rotator cuff tear, rotator cuff tear arthropathy, severe shoulder arthritis with bony destruction, or severe proximal humerus fractures. The artificial joint used in a reverse shoulder replacement was designed to be used when the rotator cuff is torn or damaged, and has proven to be a good option in other severe shoulder injuries.
Your surgeon will guide you to the type of shoulder replacement surgery that will work best for your condition. You can ask your surgeon any questions you have about what made them choose a reverse shoulder replacement over a standard one. It’s important to have a solid understanding of what will happen during the procedure and how that will impact your recovery.
Who shouldn’t get a reverse total shoulder replacement
People with a functional rotator cuff, full range of motion, osteoporosis or an ongoing infection aren’t good candidates for a reverse total shoulder replacement. Your surgeon will talk with you about what kind of shoulder replacement is recommended based on your condition, lifestyle and goals.
Talk with your doctor about reverse total shoulder replacement
If pain in your shoulder caused by a torn rotator cuff or arthritis is making it difficult to do the activities you love, it might be time to talk with a doctor about your concerns.
At TRIA, our orthopedic surgeons set the standard of care when it comes to joint care and joint replacement surgery. We make it as simple as possible to get the care you need when you need it. We’ll talk with you about whether we recommend a standard or reverse total shoulder replacement and answer any questions you have. Most importantly, you’ll make the final choice about which replacement best fits your needs.
Our team of orthopedic experts will be by your side during every step of the recovery whether you need physical therapy to regain your shoulder function after surgery, sports medicine to get you back in the game or other follow-up care to help you feel your best. No matter what you need, we’ll work together to create a treatment plan that’s tailored to you.
