What is a Reverse Total Shoulder Replacement?
Reverse shoulder joint replacement is a procedure designed to reconstruct a shoulder with advanced stages of arthritis and loss of motion and function. If a normal anatomic shoulder cannot be used, it may be necessary to make changes in the normal mechanics of the shoulder. In a Reverse TSA, the anatomy of the shoulder is reversed. The ball portion of the implant is placed on the bony socket and the socket portion is placed onto the upper end of the humerus. The deltoid muscle is then able to raise the arm using the prosthesis as a fulcrum. The Reverse TSA has been tested throughout the world since 1985 and became FDA approved in the U.S. in 2003.
Who is a Good Candidate for Reverse Total Shoulder Replacement?
- Cuff tear arthopathy (CTA) is an arthritic shoulder that forms when the rotator cuff muscles became weak and non-functional secondary to a chronic rotator cuff tear. The shoulder can become painful with limited function of the arm.
- Arthritic shoulder with severe deformity of the joint. The reverse total shoulder arthroplasty (TSA) allows the surgeon to reconstruct the shoulder and return function with the prosthesis.
- Fracture sequela – an old fracture of the proximal humerus may heal in poor alignment and heal in a nonanatomic fashion leading to pain and arthritis of the shoulder.
- Failed or loose total shoulder replacement can be revised with a Reverse TSA.
- NSAIDs – non steroidal anti-inflammatory medicines can provide systematic relief of pain.
- PT – physical therapy can help to improve function and strength.
- Cortisone shots can be used to decrease inflammation and pain.
The surgery is about a 2 hour operative procedure which can be done as a same day surgery or as a one day admission. After surgery, the patient will wear a sling for 4-6 weeks but will be able to do waste level activities within a week. Rehab is significantly easier than a rotator cuff repair and recovery varies from 6 weeks to 3 months.