Reverse Shoulder Replacement

The shoulder joint, known for its extensive range of motion, is a complex structure composed of bones, ligaments, muscles, blood vessels, and nerves. This versatility also makes the shoulder joint vulnerable to injury.

The shoulder consists of three main bones: the humerus (upper arm bone), the clavicle (collarbone), and the acromion, which is part of the scapula (shoulder blade) at the top of the shoulder. These bones form four joints, with the primary one being the glenohumeral joint, where the humerus and scapula meet. Though similar to a ball-and-socket joint, this shallow joint is stabilized by ligaments called the joint capsule, holding the humerus in position.

Shoulder bones are interconnected by various ligaments, while tendons attach muscles to the bones, allowing movement. The rotator cuff tendons link strong shoulder muscles to the humerus, enabling rotation and various arm movements. The subacromial bursa, a lubricating structure, allows smooth, pain-free movement of the rotator cuff tendons.

Reverse shoulder replacement stabilizes the shoulder and restores pain-free function in cases of complex shoulder conditions, such as arthritis with a rotator cuff tear or vascular issues like avascular necrosis. In severe degenerative cases, cartilage may wear down, causing pain and limiting mobility, while damaged rotator cuff tendons may lose function. This surgery is also considered for individuals with unsuccessful traditional shoulder replacements.

As degenerative shoulder conditions progress, they can damage shoulder structures, leading to pain and reduced movement. For some, reverse shoulder replacement may restore motion even with severe loss of mobility, which is vital for daily tasks and recreational activities.

Doctors can diagnose shoulder degeneration with a physical exam that includes arm and shoulder movements to assess muscle strength, range of motion, and stability. Imaging tests like X-rays can reveal bone spurs and cartilage loss, while CT or MRI scans offer detailed views for more complex cases.

Reverse shoulder replacement surgery is advised for those with irreparable rotator cuff tears, severe arthritis with tendon damage, or a history of unsuccessful shoulder surgeries. Unlike traditional replacements, reverse shoulder replacement switches the ball and socket positions in the joint, allowing the deltoid muscle to lift the arm in place of the impaired rotator cuff.

This inpatient procedure involves an incision at the front of the shoulder, removal of the humerus head, and preparation of the bone socket. The surgeon secures a base plate to the glenoid and attaches the artificial socket to the humerus. The ball is then attached to the glenoid, and the incision is closed.