Specialized Shoulder Care in Colorado Springs

Reverse Shoulder Replacement

Colorado Springs Orthopaedic Group

Your shoulder is one of the body's most mobile joints, allowing you to reach, lift, rotate, and perform countless everyday movements. Because of this mobility, the shoulder can also be susceptible to injuries, overuse, arthritis, and other conditions that cause pain and limit movement.

CSOG provides comprehensive evaluation and treatment for a wide range of shoulder conditions, from sports injuries and tendon problems to arthritis, instability, and fractures. Depending on your condition, treatment may include physical therapy, activity modification, medications, injections, minimally invasive procedures, or surgery.

Our shoulder specialists take the time to understand your symptoms, activity level, and goals so you can receive treatment designed to reduce pain, improve function, and help you get back to the activities that are important to you.

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What is Reverse Shoulder Replacement?

Conventional surgical methods such as total shoulder joint replacement are not very effective in the treatment of rotator cuff arthropathy. Reverse total shoulder replacement is an advanced surgical technique specifically designed for rotator cuff tear arthropathy, a condition where you suffer from both shoulder arthritis and a rotator cuff tear.

What is the Difference between Conventional and Reverse Shoulder Replacement?

Conventional shoulder replacement surgery involves replacing the ball of the humerus with a metal ball and the glenoid cavity of the shoulder blade (scapula) with a plastic socket. If this surgery is used to treat rotator cuff arthropathy, it may result in implant loosening due to the torn rotator cuff. Therefore, a specifically designed surgery was developed called reverse total shoulder replacement to be employed in such cases.

In reverse total shoulder replacement, the placement of the artificial components is essentially reversed. In other words, the humeral ball is placed in the glenoid cavity of the shoulder blade (scapula) and the plastic socket is placed on top of the arm bone. This design makes efficient use of the deltoid muscle, the large shoulder muscle, to compensate for the torn rotator cuff.

Who are the Ideal candidates for Reverse Shoulder Replacement?

Reverse total shoulder replacement may be recommended for the following conditions:

• Completely torn rotator cuff that is difficult to repair
• Presence of rotator cuff tear arthropathy
• Previous unsuccessful shoulder replacement
• Severe shoulder pain and difficulty in performing overhead activities
• Continued pain despite other treatments such as rest, medications, cortisone injections and physical therapy

What is the Procedure for Reverse Shoulder Replacement?

Reverse total shoulder replacement surgery is performed under general anesthesia.

• CSOG makes an incision over the affected shoulder to expose the joint.
• The humerus is separated from the glenoid socket of the scapula.
• The arthritic parts of the humeral head and the socket are removed and prepared for the insertion of the artificial components.
• The artificial components include the metal ball that is screwed into the shoulder socket and the plastic cup that is cemented into the upper arm bone.
• The artificial components are fixed in place.
• The joint capsule is stitched together, the tissues approximated and the wound is closed with sutures.

What Does Postoperative Care for Reverse Shoulder Replacement Involve?

You can get out of bed on the same day of the surgery but will usually have to stay in the hospital for 1-2 days. General postoperative instructions include:

• Take all prescribed medications as instructed.
• Undergo a gentle range of motion exercises to increase your shoulder mobility.
• Physical therapy will be recommended to strengthen the shoulder and improve flexibility.
• Avoid overhead activities for at least 6 weeks.
• Don’t push yourself up out of a chair or bed using your shoulder muscles.
• Avoid lifting heavy objects.

What are the Risks and Complications of Reverse Shoulder Replacement?

The possible risks and complications associated with reverse total shoulder replacement surgery include:

• Infection
• Dislocation or instability of the implanted joint
• Fracture of the humerus or scapula
• Damage to nerves or blood vessels
• Blood clots (deep vein thrombosis)
• Wound irritation
• Arm length discrepancies
• Wearing out of the components