Reverse Total Shoulder Replacement

Overview
During this procedure, the surgeon replaces a damaged shoulder joint with artificial components that reverse the structure of the shoulder. This procedure is most often used for patients who have had a failed total shoulder replacement. It is also helpful for patients who have had a complete tear of the rotator cuff, especially those whose injuries have led to an arthritic condition called cuff tear arthropathy.

Implants
The implants used in the procedure will reverse the position of the shoulder's ball and socket. The ball will be implanted in the glenoid, and the socket will be placed in the end of the humerus. Reversing the joint will allow the patient to control the arm with the deltoid muscle instead of the damaged muscles of the rotator cuff.

Preparation
In preparation for the procedure, general or regional anesthetic is administered. The surgeon cleans the skin and creates an incision along the top or the front of the shoulder.

Humerus Component
The surgeon carefully removes the head of the humerus. The upper portion of this bone is hollowed out, and a metal socket component is inserted. It may be secured with bone cement. The socket cup is attached to the top of this implant.

Glenoid Component
Next, the surgeon reshapes the glenoid. The socket is modified to create a stable surface. The surgeon implants the new ball component. The ball and socket components are aligned to form the new joint.

End Of Procedure
When the procedure is complete, the incision is closed and bandaged. The arm is placed in a sling. Typically, the patient will be able to leave the hospital two or three days after the surgery. Physical therapy will be required to regain shoulder strength and range of motion.