Shoulder arthritis can cause significant damage to the bones in a shoulder joint. A reverse shoulder replacement can be used to replace the damaged joint when other conditions, such as rotator cuff tear arthropathy, are affecting the shoulder. Read on to learn how the replacement works, who it is suitable for, and what to expect from the procedure.
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Reverse shoulder replacement is a procedure used to replace a shoulder joint. The way the replacement works is in reverse to a conventional (total) shoulder replacement.
A total shoulder replacement mimics the normal function of a shoulder joint. A metal ball is attached to the humerus (upper arm bone) and a plastic cup is fitted on the shoulder socket (glenoid).
With a reverse shoulder replacement, the plastic cup and metal ball are in a switched position. The plastic cup is fitted to the upper arm bone and the metal ball is attached to the shoulder blade.
A reverse total shoulder replacement works differently from a conventional shoulder replacement. With a conventional shoulder replacement, the rotator cuff muscles help to move the shoulder through the range of motion and give power to shoulder movements. This is similar to how a healthy shoulder works.
Reverse shoulder replacements rely on the deltoid muscle instead of the rotator cuff to move and power the arm. This makes it a better treatment for those with torn rotator cuff tendons or rotator cuff tear arthropathy.
You may be a candidate for reverse shoulder surgery if you have:
Your doctor may likely try non-surgical treatments, such as rest, medications, cortisone injections, and/or physical therapy first. If these have not relieved your shoulder pain, then they may recommend reverse shoulder surgery.
The reverse shoulder replacement procedure is an open surgery procedure where your surgeon will need to make an incision to access the joint. Your surgeon will first remove the damaged bone before replacing the joint with the replacement components.
Once your shoulder surgery is finished, you will be transferred to a room to recover from the general anesthesia. Most patients should be able to return home on the same day as the surgery, while others may need to stay overnight. Your doctor will let you know which is necessary in your case.
You will be given medication to fight off potential infection, as well as medication to reduce pain. Pain medication can help aid recovery. It may include opioids, local anesthetics, or non-steroidal anti-inflammatory drugs (NSAIDs).
Your arm must be supported by a sling during the initial phase of recovery. Additionally, physical therapy exercises may be given to help strengthen the joint and work on your range of motion. This will help your shoulder to remain flexible and strong.
You can expect to return to some daily activities—such as eating, dressing, and grooming—within a few days after surgery. You may be asked to attend a follow-up visit in the office for X-rays to monitor your shoulder.
Your surgeon will make a personalized analysis to see whether a reverse shoulder replacement is suitable for your condition. The surgical risks of a reverse shoulder replacement could include bleeding, infection, or nerve damage.
Complications particular to a reverse shoulder replacement include wear to the components, loosening of the replacement joint, and potential dislocation. If you experience any of these complications, your surgeon may need to redo the procedure.
After you have recovered from the surgery, you will likely be able to lift your arm to just above your shoulder height. This will allow you to touch the top of your head or reach into a cupboard.
Most patients are satisfied with the outcome of a reverse shoulder procedure. It can provide excellent pain relief from pain caused by shoulder arthritis.
Brent J. Morris, MD, understands the impact shoulder pain and limited mobility can have on your life. Our office is committed to providing cutting-edge solutions like reverse shoulder replacement surgery. With the expertise and personalized care provided by Dr. Morris, we aim to help you rediscover comfort, mobility, and an active lifestyle.
Ready to regain your shoulder function and freedom from pain? Contact us for a consultation. Our office can be found in Lexington, Kentucky.
Medically reviewed by Brent J. Morris, MD
Reverse shoulder replacement relies on the deltoid muscle rather than the rotator cuff to move the arm. This allows patients with severe rotator cuff damage to regain functional movement, even though the shoulder may not feel or function exactly like a normal joint.
While longevity varies by patient, reverse shoulder replacements are designed to last many years. Implant lifespan depends on factors such as activity level, bone quality, and overall health.
Most patients regain the ability to perform daily activities comfortably, but heavy lifting and repetitive overhead use may be limited to protect the implant. Your surgeon will provide specific guidelines based on your recovery.
Reverse shoulder replacement is more commonly performed in older adults, but it may also be recommended for younger patients with severe shoulder damage, irreparable rotator cuff tears, or failed previous surgeries.
The time it takes to return to work varies depending on job demands and individual recovery. Light activities may resume within a few weeks, while more physically demanding tasks can take several months. Your surgeon will guide your return based on healing and progress in therapy.
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