A standard total shoulder replacement uses the outer part of the upper arm bone to replace the socket. A reverse shoulder replacement is not as common, but it may be considered when the humerus (upper arm bone) has more damage or arthritis, and you’re still able to move your arm.

During a reverse shoulder replacement surgery, a surgeon removes the rounded head of the upper arm bone. Using screws and special tools, you surgeon attaches a plastic socket to the remaining bone. The surgeon also removes part of the socket of the shoulder blade. This is then replaced with a metal ball. The metal ball can then move around inside the socket that attaches to the upper arm bone.

An eligible patient for reverse shoulder replacement is one who has shoulder pain and is not able to achieve satisfactory results with standard shoulder replacement.

The main reason why standard shoulder replacement may not be successful is because the shoulder anatomy of the patient may render it impossible to achieve a normal range of motion or the implant may not be positioned optimally.

An indication for reverse shoulder is when a standard total shoulder replacement cannot give the patient a pain free and functional arm.

Before your surgery, you may need imaging tests. An x-ray will give your provider information about the bones in your shoulder, a CT scan will provide a detailed image of the bones, and an MRI will give your provider more detailed information about the soft tissue around the bones.

The reverse shoulder replacement is an advanced procedure in orthopedics that replaces the damaged-cartilage joint with a prosthetic implant. The surgery is a specialized form of partial shoulder arthroplasty, a surgical procedure which involves the surgical replacement of the ball and socket joint between the upper arm bone (humerus) and the glenoid portion of the scapula. The surgery is performed in two stages.

In stage one, called “explantation”, the surgeon carefully disassembles the affected joint though an incision over the top of the patient’s shoulder. The ball-and-socket joint is separated, and the inner shell of bone and cartilage is removed from within the socket. The lower end of the humerus is then drill down to receive a metal sleeve prosthesis, into which a plastic ball will later be inserted.

Stage 2 involves re-setting this new polyethylene hollow cylinder over top of humerus (metal sleeve), reattaching muscle tendons to it, and then remounting this new shoulder joint into its normal position overtop of shoulder blade (scapula), where it is secured in place with screws.

After undergoing reverse shoulder replacement surgery, your arm will probably be in a sling for several weeks.

Before you leave the hospital, you’ll have a plan for your recovery. Physical therapy will begin as soon as it is safe for you to do so.

The reverse prosthesis provides good pain relief. The amount of relief varies widely. The reason for the surgery often determines how much pain relief is obtained.

Most patients can reach their own head without tilting the head forward. Some patients experience shoulder stiffness.

As with any surgical procedure, reverse shoulder replacement carries potential risks. These may include:

• • Infection
  • Excess blood loss
  • Damage to the surrounding nerves
  • Break (fracture) of one of the shoulder bones
  • Dislocation of the artificial joint

Reverse shoulder replacement surgery relieves pain by changing the motion of the ball and socket in an arthritic shoulder.

Joint Stabilization – The shoulder joint is strengthened with reverse shoulder replacement, arguably becoming stronger and more durable than the original shoulder.

A reverse shoulder replacement may be used when other treatments fail or if the patient dislocated their shoulder frequently.

You may benefit from a reverse shoulder replacement if your:

• Previous total shoulder replacement failed
• Rotator cuff is completely torn
• Arthritis is severe with rotator cuff tearing
• Arm weakness is severe