Reverse Total Shoulder Replacement

A reverse total shoulder replacement is an orthopaedic treatment that can offer pain relief for those with damage to the shoulder joint and rotator cuff. This article will explore what the procedure involves and when it may be recommended as a treatment.

Overview of a reverse total shoulder replacement

The shoulder is a complex joint that can suffer damage from wear-and-tear or injury. The joint is composed of the ball (or the head of the upper arm bone) and the socket (or the rounded area in the shoulder blade called the glenoid). In a conventional shoulder replacement, the socket is replaced with a plastic cup, and the head of the upper arm bone is replaced with a metal ball. The artificial joint can then move smoothly without pain.

A reverse total shoulder replacement switches the placement of the implants, meaning the artificial socket is attached to the head of the upper arm bone while the metal ball is attached to the glenoid. This replacement strategy allows the deltoid muscle to power arm movements rather than the rotator cuff muscles.

Orthopaedic specialists are more likely to recommend this procedure for patients who have had a failed conventional total shoulder replacement or who have a rotator cuff injury or tear. A reverse total shoulder replacement takes pressure off the damaged rotator cuff and transfers the responsibility to the deltoid muscle, which is important for those with severe rotator cuff tears or injuries.

Causes of rotator cuff injuries

A reverse total shoulder replacement is often performed to help relieve pain from arthritis that has developed in the shoulder joint. This particular procedure is often recommended when the rotator cuff that surrounds and supports the shoulder joint has suffered damage, as well.

Common causes of rotator cuff injuries include

Age-related wear-and-tear: Over time, wear-and-tear can start to affect the integrity of the rotator cuff. Wear-and-tear is also a common cause of osteoarthritis in the shoulder joint in the first place.
Repetitive stress: If you are particularly physically active, your shoulder joint and rotator cuff may suffer damage from the repetitive strain of activity. Athletes like swimmers and throwers are most vulnerable to this kind of shoulder injury.
Injury: Sudden strain on the shoulder from falling or lifting a heavy object can result in damage to the cartilage and rotator cuff.

Symptoms of rotator cuff injuries

Rotator cuff injuries often lead to the following symptoms:

Pain in the shoulder
Difficulty moving your arm and shoulder
Weakness or instability in the shoulder
Limited range of motion

If you’re experiencing these symptoms and suspect you may have a rotator cuff injury, seek medical attention to see how it can be treated.

Treatments for rotator cuff injuries: reverse total shoulder replacement

For those who have developed arthritis in the shoulder joint with a corresponding rotator cuff injury, a reverse total shoulder replacement may be recommended. Rather than a conventional total shoulder replacement that still leaves the shoulder relying on the rotator cuff muscles, this procedure offers better relief for a damaged rotator cuff.

Following a reverse total shoulder replacement, physical therapy will be necessary to restore functioning and range of motion to the arm and shoulder.

This procedure can provide substantial pain relief. An orthopaedic specialist will determine whether either a conventional total shoulder replacement or a reverse total shoulder replacement would be beneficial based on the individual case.