Reverse Shoulder Replacement
Reverse shoulder replacement, also known as reverse total shoulder arthroplasty, is a type of shoulder surgery used primarily to treat specific types of shoulder problems, particularly when traditional shoulder replacement might not be effective. Let's break down the key aspects:
Causes and Indications for Surgery
Reverse shoulder replacement is typically indicated for:
Rotator Cuff Tear Arthropathy: This is a condition where the patient has both a severe rotator cuff tear and arthritis of the shoulder joint. The rotator cuff can no longer function properly, leading to painful and limited motion.
Severe Shoulder Arthritis with Cuff Tear: In cases where there is significant arthritis of the shoulder joint accompanied by a rotator cuff tear, a conventional total shoulder replacement might not be effective.
Complex Fractures: Particularly in the elderly, certain complex fractures of the shoulder joint might be more effectively treated with this procedure.
Revision of Previous Shoulder Replacement: When a previous shoulder replacement fails, a reverse total shoulder replacement might be considered.
Tumor of the Shoulder Joint: In rare cases, if there's a tumor in the shoulder joint, this procedure might be indicated.
How It Works
In a standard shoulder replacement, the damaged ball (humeral head) at the top of the upper arm bone is replaced with an artificial ball, and the socket (glenoid) is fitted with a new smooth surface. However, in a reverse shoulder replacement:
The normal ball-and-socket structure is reversed. The ball portion is attached to the shoulder blade (where the socket normally is), and the artificial socket is attached to the top of the upper arm bone.
This design relies more on the deltoid muscle instead of the rotator cuff to move and stabilize the shoulder.
Surgery
The procedure typically involves:
Anesthesia: The surgery is conducted under general anesthesia.
Incision: An incision is made over the shoulder to expose the joint.
Replacement: The damaged bone is removed, and the new artificial components are fixed in place.
Closure: The incision is closed with sutures or staples.
Recovery: Post-surgery, patients typically need physical therapy to regain motion and strength in the shoulder.
Recovery and Risks
Recovery: It can take several weeks to months to fully recover. Physical therapy is crucial for regaining strength and range of motion.
Risks: As with any major surgery, risks include infection, blood clots, nerve damage, and complications related to anesthesia.
It's important to note that each patient's case is unique, and the decision to undergo reverse shoulder replacement should be made in consultation with an orthopedic surgeon who can evaluate the specific needs and health status of the individual.