Arthritic degeneration or structural injury of the shoulder may affect anyone, at any age, and these conditions are often associated with chronic, debilitating pain. In cases of soft tissue damage involving the rotator cuff, it may become extremely painful to lift the arm above the shoulder to perform simple, daily tasks such as dressing or bathing. Fortunately, when the damage to both the rotator cuff and the underlying glenohumeral joint is too severe to perform a repair of the rotator cuff, reverse total shoulder replacement offers a safe and effective way to relieve pain and restore mobility and function to people suffering from severe shoulder damage.
The Joint Surgery Center of Excellence offers a team of renowned orthopedic surgeons who possess extensive training in the most advanced shoulder replacement techniques. Our commitment to compassionate care and an individualized treatment approach result in better outcomes and exceptional patient satisfaction.
To schedule a consultation with a Los Angeles orthopedic surgeon, please contact us by calling (888) 318-2842.
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What Is Reverse Total Shoulder Replacement
Reverse total shoulder replacement involves replacing the bony ball-and-socket joint in the shoulder with special prostheses, similar to traditional total replacement. However, in this procedure, the structures are reversed: the socket prosthesis replaces the rounded end of the humerus (upper arm bone), while the metal ball is implanted into the glenoid fossa (shoulder socket).
The reversal takes place in order to allow the deltoid muscle to act as the primary elevator of the humerus. If the rotator cuff tendons are too severely torn, damaged, or atrophied to repair – and the patient is experiencing considerable pain and weakness of the shoulder – then the reversed shapes of the implants creates a new, disease-free mechanism for moving the arm.
Candidates For This Procedure
People with the following symptoms may be excellent candidates for reverse total shoulder replacements:
- Severe arthritic degeneration of the glenohumeral joint of the shoulder which interferes with daily activities
- Significantly damaged rotator cuff with severe arm weakness and decreased range of motion
- Persisting pain and weakness, and failure to improve, after a traditional total shoulder replacement procedure
- Failure to significantly improve after treatment with more conservative therapies such as anti-inflammatory medication, steroid injections or physical therapy
A traditional shoulder replacement relies on a patient’s intact rotator cuff muscles to lift and rotate the arm above shoulder height, as it closely resembles the bony anatomy of an uninjured shoulder. For individuals with an irreparably damaged rotator cuff in addition to severe joint degeneration, a total shoulder replacement is not likely to provide effective pain relief. Our surgeons work closely with each patient to review diagnostic findings and ensure that the best shoulder replacement procedure is selected to result in the most effective outcome to help the patient return to the desired level of activity as best as possible.
Details of the Procedure
Similar to a traditional shoulder joint replacement, reverse total shoulder replacement is an open surgery lasting approximately two hours. With the patient under general anesthesia, a 4 to 6-inch incision is made in the shoulder. Damaged cartilage and debris from a torn rotator cuff are then meticulously removed from the shoulder, leaving as much healthy tissue intact as possible. Small portions of bone from the surface of the humerus and the glenoid shoulder joint may be removed to provide an optimal surface for the implant.
Next, a specially made ball prosthesis will be fixed into the shoulder socket. An artificial socket, attached to a long stem, is then inserted into the humerus and fixed into place for additional stability. The implant is designed to replicate the shape and size of your shoulder joint (in reverse) to restore pain-free movement of the shoulder. After the implants are securely in place, the incision is closed in layers.
Recovery From Reverse Total Shoulder Replacement
At the Joint Surgery Center of Excellence, our highly skilled orthopedic surgeons can often perform reverse total shoulder replacement as an outpatient procedure, in which patients can return home within 24 hours of surgery. Most patients experience a dramatic decrease in the pain associated with shoulder joint degeneration and painful arthritis after surgery.
Please Note: The long-term success of this procedure is highly dependent on a patient’s commitment to physical therapy rehabilitation for the shoulder. Patients must also adhere to temporary post-operative movement restrictions to protect the integrity of the implant.
Contact a Los Angeles Orthopedic Surgeon
Reverse total shoulder replacement is a highly technical procedure that should only be performed by an experienced orthopedic surgeon. The Joint Surgery Center of Excellence houses a team of highly skilled orthopedic surgeons specializing in joint replacement surgery. Our shoulder surgeons are trained in the most advanced shoulder replacement procedures and are leaders in the field of joint preservation.
For more information on shoulder replacement – or to schedule a consultation with one of our renowned orthopedic shoulder surgeons – contact us at (888) 318-2842.
Next, learn about partial shoulder replacement.