Reverse total shoulder replacement

The human shoulder is a ball-and-socket joint. The upper arm bone is the “ball,” which sits and rotates in the shoulder’s “socket.” In a standard shoulder replacement, the ball and socket are replaced with artificial parts. But they work the same way they did before.

In a reverse total shoulder replacement, the relationship is the opposite. The upper arm bone becomes the socket, and the socket becomes the ball.
 

After a standard total replacement, the rotator cuff muscles help the shoulder get back to normal. They also help keep the new artificial parts in place. But if the rotator cuff tear is large, or if there is serious shoulder arthritis, these muscles no longer work.

The reverse total shoulder replacement makes the main shoulder muscle more efficient. This allows it to do the job of the rotator cuff muscles.

The surgeon makes an incision in the shoulder and frees the upper arm bone from the shoulder socket. The head of the upper arm bone is removed and hollowed out. A metal socket implant is inserted and secured into the top of the arm bone.

A plastic socket cup is then attached to the top of the implant. The socket is reshaped to create a flat surface. The base of the ball is attached to it with screws, then the ball is pressed into place.

After the surgery, patients usually spend a day in the hospital. During that time, they meet with a physical or occupational therapist. He or she will create a program designed to increase range of motion and shoulder strength.

Sessions will be held at the therapist’s office or the patient’s home. Physical therapy usually lasts six to eight weeks.

As the shoulder gets better, the therapist will create a home exercise plan. Recovery usually takes four to six months. But patients often notice improvements for up to two years after surgery.