Reverse Total Shoulder Replacement Surgery
Daniel Heaston, MD, is an orthopedic surgeon at Banner Mountain Vista Orthopaedic Clinic in Greeley, Colo. He can be reached at (970) 348-0020.
Question: What is reverse total shoulder replacement and who should have it?
Answer: In this procedure, the arthritic or damaged ball in the shoulder joint is replaced by a socket fixed to the arm bone with a stem that fits within it. A metal ball is fixed to the bone of the damaged socket with screws.
This is the opposite of a conventional total shoulder replacement in which a metal ball with a stem is fitted inside the arm bone and the socket is resurfaced with a high-density polyethylene component.
The reverse total shoulder replacement can restore comfort and function to shoulders with arthritis and massive defects in the rotator cuff. With these conditions, the deltoid slackens so that it can no longer raise the hand to carry out normal activities. Conventional shoulder replacement cannot restore the necessary stability in that situation. The configuration of the reverse total shoulder procedure provides stability because the muscles around the shoulder compress the ball and socket together.
A reverse total shoulder replacement should only be considered if the condition of the shoulder is limiting the quality of the patient’s life and after unsuccessful efforts at physical therapy and the use of mild analgesics, or following a failed conventional shoulder replacement.
The ideal patient is healthy, active, motivated and committed to complying with the generally conservative rehabilitation program.
This procedure is not designed for patients with heavy use or sports requirements. It is designed to help the patient return to gentle activities of daily living.
Reviewed December 2010