Reverse Shoulder Replacement Surgery

Individuals with rotator cuff tear arthritis (occurrence of shoulder arthritis and rotator cuff tear), a fully torn rotator cuff that is difficult to repair or prior failed shoulder replacement are candidates for reverse shoulder replacement. At the Orthopedic Institute of North Texas (OINT, Dr. Vikas Patel, our upper extremity specialist, provides diagnosis and individualized nonoperative and operative treatments for the shoulder including reverse shoulder replacement surgery.

What is a Reverse Shoulder Replacement?

Conventional surgical methods such as total shoulder joint replacement are not very effective in the treatment of rotator cuff arthritis. Reverse total shoulder replacement is an advanced surgical technique specifically designed for rotator cuff tear arthropathy, a condition where you suffer from both shoulder arthritis and a rotator cuff tear. 

Differences between Conventional or Anatomic and Reverse Shoulder Replacement

Conventional or anatomic shoulder replacement surgery involves replacing the ball of the humerus with a metal ball and the glenoid cavity of the shoulder blade (scapula) with a plastic socket. If this surgery is used to treat rotator cuff arthropathy, it may result in implant loosening due to the torn rotator cuff. Therefore, a specifically designed surgery was developed called reverse total shoulder replacement to be employed in such cases. 

In reverse total shoulder replacement, the placement of the artificial components is essentially reversed. In other words, the humeral ball is placed in the glenoid cavity of the shoulder blade (scapula) and the plastic socket is placed on top of the arm bone. This design makes efficient use of the deltoid muscle, the large shoulder muscle, to compensate for the torn rotator cuff.

Ideal candidates for Reverse Shoulder Replacement

Reverse total shoulder replacement may be recommended for the following conditions:

  • Completely torn rotator cuff that is difficult to repair
  • Presence of rotator cuff tear arthritis
  • Previous unsuccessful shoulder replacement
  • Severe shoulder pain and difficulty in performing overhead activities
  • Continued pain despite other treatments such as rest, medications, cortisone injections and physical therapy 

Reverse Shoulder Replacement Procedure

Reverse total shoulder replacement surgery is performed under general anesthesia.

  • Your surgeon makes an incision over the affected shoulder to expose the joint.
  • The humerus is separated from the glenoid socket of the scapula.
  • The arthritic parts of the humeral head and the socket are removed and prepared for the insertion of the artificial components.
  • The artificial components include the metal ball that is screwed into the shoulder socket and the plastic cup that is cemented into the upper arm bone.
  • The artificial components are fixed in place.
  • The joint capsule is stitched together, the tissues approximated, and the wound is closed with sutures.

Reverse Shoulder Replacement Recovery

You can get out of bed on the same day of the surgery but will usually have to stay in the hospital for 1-2 days. General postoperative instructions include: 

  • Take all prescribed medications as instructed.
  • Undergo a gentle range of motion exercises to increase your shoulder mobility.
  • Physical therapy will be recommended to strengthen the shoulder and improve flexibility.
  • Avoid overhead activities for at least 6 weeks.
  • Don’t push yourself up out of a chair or bed using your shoulder muscles.
  • Avoid lifting heavy objects.

Risks and Complications of Reverse Shoulder Replacement

The possible risks and complications associated with reverse total shoulder replacement surgery include:

  • Infection 
  • Dislocation or instability of the implanted joint
  • Fracture of the humerus or scapula
  • Damage to nerves or blood vessels
  • Blood clots (deep vein thrombosis)
  • Wound irritation
  • Arm length discrepancies
  • Wearing out of the components

Why Reverse Shoulder Replacement Surgery with Dr. Vikas Patel ?

The thought of shoulder replacement surgery can be very stressful to patients. Dr. Vikas Patel understands this and delivers personalized care centered around you. From the moment you become a patient, through the surgery and during the post-operative period, you will get the undivided attention of Dr. Patel as well as direct access to him. He will make sure to alleviate those fears and uncertainties surrounding the surgery.

Dr. Patel is a fellowship trained shoulder and elbow surgeon, trained in the latest techniques and technologies and able to handle a wide variety of complex shoulder and elbow pathologies including revision surgeries. His training and experience allow him to handle any complexity associated with the shoulder so his patients can have an excellent outcome.

Patient Testimonials and Success Stories

This patient is 3 months out after Reverse Shoulder Replacement Surgery performed by Dr. Vikas Patel, shoulder and elbow specialist at OINT. He is now feeling great after being in pain for 5 years!

We’re so happy to see this patient thriving three months after a reverse shoulder replacement surgery with Dr. Vikas Patel. The goal for all our patients is to reduce pain and improve their quality of life for years to come. Watch his testimonial below: