Reverse Total Shoulder Replacement

What is a reverse total shoulder replacement?

The shoulder joint is commonly affected by arthritis due to the aging process, previous shoulder injuries, or other pre-existing conditions. This can lead to stiffness, pain, and disability of the shoulder that can be alleviated by a total shoulder replacement surgery. This surgery involves replacing the affected bones and cartilage of the shoulder with artificial metal and plastic components. Traditionally, this procedure requires the existing rotator cuff muscles and tendons to help “hold” the metal and plastic replacements in place within the shoulder. A reverse total shoulder replacement accomplishes the same goal as a traditional replacement, however by reversing the locations of the ball and socket components of the shoulder joint. The result allows the deltoid muscle, rather than the rotator cuff, to hold the replacements in place and give power to the arm and shoulder. Dr. Joseph Lamplot, orthopedic shoulder doctor, treats patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, who would benefit from a reverse total shoulder replacement.

Why would a reverse total shoulder replacement be recommended?

A traditional anatomic shoulder replacement relies on the muscles and tendons of the rotator cuff to provide stability, strength, and function to the resurfaced joint. However, some patients may be affected by large rotator cuff tears or other shoulder injuries which inhibit the success of a traditional anatomic replacement. These patients may benefit from a reverse total shoulder replacement because this procedure does not rely on the rotator cuff to provide support or strength to the replaced joint. The reverse total shoulder replacement utilizes the deltoid muscles, a different muscle group in the arm, to stabilize and initiate movement in the shoulder. This approach offers an alternative treatment for patients with a severely injured or non-functional rotator cuff, previously failed shoulder replacement, frequent shoulder dislocations, complex fractures, or other pathologies.

How common are reverse total shoulder replacements?

Dr. Lamplot is a highly skilled surgeon who performs approximately 5 times more reverse total shoulder replacements than traditional anatomic shoulder replacements. He finds that this procedure works better in patients with large or irreparable rotator cuff tears because this procedure does not rely on the rotator cuff for the movement of the arm following surgery. Dr. Lamplot sees that his patients who have undergone a reverse total shoulder replacement are frequently very happy with the outcome of their surgery.

How is a reverse total shoulder arthroplasty done?

This procedure is performed with a similar approach as traditional shoulder replacements. Dr. Lamplot will first make an incision to remove the injured and arthritic bone and cartilage of the affected shoulder. He will then replace the humeral head with an artificial cup-like structure. He will also place a ball-like structure into the glenoid (shoulder) socket. This effectively switches or reverses the position of the natural ball and socket shoulder joint and will allow for more fluid motion and less pain with movement of the shoulder.

How long is the recovery after a reverse total shoulder replacement?

Immediately after a reverse total shoulder replacement, the patient will remain in the hospital for observation and begin treatment with pain medication and antibiotics to prevent any infection. Many healthy patients are allowed to go home the same day as surgery. Patients will be required to wear an arm sling to assist in the healing process and will begin a physical therapy program four weeks following surgery. It is important that patients follow Dr. Lamplot’s rehabilitation instructions closely to improve healing, strength, and motion of the shoulder. A full recovery is expected to be achieved in approximately 4 to 6 months after surgery.