Reverse Shoulder Replacement

Total shoulder arthroplasty (TSA) and Reverse total shoulder arthroplasty (RTSA) are procedures to relieve shoulder pain and restore shoulder function. Shoulder arthroplasty is safe and effective and allows patients the ability to resume an active lifestyle. Recovery from a total shoulder replacement requires the patient’s commitment to extensive post-operative rehabilitation to achieve the full benefits from these procedures.

Shoulder arthroplasty is an outpatient procedure performed under general anesthesia. Benefits include same day surgery versus several days in the hospital, decreased risk of infection, less blood loss, minimal damage to soft tissues, less pain, fewer complications, reduced recovery time and faster return to recreational activities.

Total shoulder arthroplasty

Total shoulder arthroplasty (TSA) is successful, outpatient shoulder joint replacement surgery to replace a shoulder joint damaged by arthritis with man-made replacements and relies on the use of the rotator cuff tendons and muscles to function properly. Arthritis is the primary reason for a TSA. Only short incisions are needed, and there is no moving or cutting of the rotator cuff and muscles. Because there is no damage to the rotator cuff, there are no activity restrictions and recovery is faster, about three months.

People who would benefit from total shoulder arthroplasty include:

• Those who have severe shoulder pain that interferes with every day activities.
• Moderate to severe joint pain while resting, which at times is severe enough to interfere with good sleep.
• Loss of motion and/or weakness in the shoulder.
• Failure of the patient to improve with nonsurgical treatments.

However, not all patients with these conditions are candidates for TSA because they have significant rotator cuff dysfunction, rheumatoid arthritis, complex fractures of the upper arm bone and shoulder blade or other conditions that require a different approach.

Reverse total shoulder arthroplasty

When the rotator cuff is severely damaged and no longer functions, a reverse total shoulder arthroscopy (RTSA) replaces the damaged parts of the joint with man-made parts and uses the deltoid muscles to restore shoulder function. RTSA is a successful, outpatient shoulder joint replacement surgery.

Indications for a Reverse Shoulder Replacement

• Rotator Cuff Tear Arthropathy – a complex type of severe shoulder arthritis described as total loss of the rotator cuff tendons that causes destruction of the joint surfaces. Symptoms are pain, weakness and instability.
• Massive rotator cuff damage that cannot be repaired but with no arthritis
• Severe shoulder pain
• A failed previous replacement surgery
• Chronic shoulder dislocation
• A complex fracture of the shoulder joint common in the elderly
• Tumors of the shoulder joint

These patients have severe disability, loss of normal mechanics, and are unable to raise the arm away from their side beyond ninety degrees. For patients with these conditions a reverse shoulder replacement provides pain relief and improved function. The RTSA technique offers stability and does not rely on the rotator cuff muscles and tendons. The deltoid muscle is employed to restore function to the shoulder instead of the rotator cuff. The RTSA approach is perfect when the damaged shoulder needs new surfaces, but there is not enough healthy tissue to stabilize and move the shoulder.

The reverse technique does not rely on the rotator cuff to move the arm. Instead, the deltoid muscle is used to move the arm.  A reverse shoulder approach is the perfect solution when the damaged shoulder needs replacement parts, but there is not enough healthy tissue to stabilize the joint and move the arm.

Risks are the same for a TSA and an RTSA and include bleeding, infection, and nerve damage.  Recovery after surgery comprises pain management, range of motion exercises, and physical therapy to improve strength and flexibility.  You will receive complete instructions of the do’s and don’ts after surgery. After healing your function will improve.

RTSA is complex procedure that requires specialized technical skills performed by a team of specialists experienced in this procedure. Ortho Illinois offers board-certified, fellowship-trained orthopedic surgeons with the expertise required to perform this highly technical procedure.  We provide an unsurpassed continuum of care by a team of surgeons, physiatrists and physical and occupational therapists focused on your successful surgery and recovery. Ortho Illinois has offices in Algonquin, Elgin, and Rockford for your convenience. Contact us at 815-398-9491 to schedule a consultation and the right diagnosis and treatment.