Reverse Shoulder Arthroplasty: Is it right for you?

The number of shoulder arthroplasty  or shoulder replacement surgeries performed each year in the United States is increasing with overall estimates from 55,000 to 80,000.

Of these, about half are “reverse” shoulder arthroplasties (RSAs), in which the normal anatomy of the shoulder is switched.

In the healthy shoulder the ball (top of the humerus) fit into the cup (glenoid socket) and is held in the shoulder socket by several muscles and tendons, including the rotator cuff tendon.

In Reverse Shoulder Arthroplasty the anatomy of the shoulder is reversed. This reverse approach was approved in the United States by the U.S. Food and Drug Administration in 2003. Since then, it has become the procedure of choice when the patient has massive rotator cuff arthropathy or tear.

Patients who have a large rotator cuff tear the rotator cuff tendon is no longer functioning are good candidates for reverse total shoulder replacement. Rather than relying on the rotator cuff to power the shoulder replacement,  reverse total shoulder replacement relies on the deltoid muscle, to power and position the arm.

How is a Reverse Shoulder Arthroplasty Performed

A reverse total shoulder replacement works better for people with rotator cuff tear  because it relies on the deltoid muscles to move the arm. In a healthy shoulder, the rotator cuff muscles help position and power the arm during range of motion. A conventional replacement device also uses the rotator cuff muscles to function properly.

(Left) Rotator cuff tear. (Right) The reverse total shoulder replacement allows other muscles to do the work of the damaged rotator cuff tendons.

Are you a candidate for reverse total shoulder replacement?

Here are some of the symptoms that may make you a candidate for reverse total shoulder replacement:

  • A completely torn rotator cuff that cannot be repaired
  • Cuff tear arthropathy
  • A previous shoulder replacement that was unsuccessful
  • Severe shoulder pain and difficulty lifting your arm away from your side or over your head
  • Tried other treatments, such as rest, medications, cortisone injections, and physical therapy, that have not relieved shoulder pain

Surgical Procedure

Reverse total shoulder replacement procedure will replace your shoulder joint with an artificial one. The surgery typically takes about two hours to complete.

Your surgeon will make an incision either on the front or the top of your shoulder.  Damaged bone will be removed. The new components will be positioned and the shoulder repaired to restore function to your shoulder.

The image below is a typical xray of the components in a reverse total shoulder replacement. Note how the ball in now on the shoulder versus the humerus bone.

Post Surgery Rehabilitation

When you leave the hospital, your arm will be immobilized. The aim will be to perform exercises to increase your mobility, range of motion and endurance.

A few weeks after surgery, you should be able to resume regular activities like: dressing, grooming and light activity. Weight bearing activity should be avoided for the first 6 weeks or so. This will depend on your rate of healing and examination by your surgeon.

Would you like to know more or determine if you are a candidate for reverse total shoulder replacement?

Call us at 580-353-8600 to schedule an appointment.

904 SW 38th Street, Lawton, OK, 73505 Directions


Source: AAOS