Reverse Total Shoulder Replacement Print E-mail
A Reverse Total Shoulder Replacement is a surgical procedure that is utilized to replace the arthritic or injured shoulder that is rotator cuff deficient. The joint is comprised of several structures- the bone components consist of the humerus and the glenoid; the soft tissue is made up of the rotator cuff complex and the labrum. During the procedure the bone structures are cut with removal of the ends of the humerus and the glenoid.

Fixation of the replacement is based upon patient age, demands and medical conditions. The surgeon will discuss these various options and utilize the most appropriate replacement.

When is a Reverse Total Shoulder Replacement Needed?

Reverse Total shoulder replacement is considered with patients who have exhausted all other means of repair. Often a patient fails trials of activity modification, gentle physical therapy to maintain muscle tone, anti-inflammatory medication and occasional pain medication then the physician may recommend the reverse total shoulder. Generally it is utilized with patients who have rotator cuff arthropathy of the shoulder. This procedure can provide remarkable relief from pain and allow for daily activities.

What to expect with a Reverse Total Shoulder Replacement?

The replacement will provide patients with pain relief. It will allow patients to carry out normal activities of daily living. Motion and stiffness are improved after replacement. Recreational activities with lower demand may be an option based on physician recommendations.

What are some risks associated with Reverse Total Shoulder Replacement?

As with all joint replacements, this is considered a major surgery. There are a variety of complications which can occur with replacement or afterwards. Oftentimes prior to surgery the patient will have a medical work up completed to help avoid complications.

Surgical complications or risks include: blood clots in an extremity, pneumonia, blood clots in the lung(s), wound infection, anesthesia issues, stiffness, instability of the joint, or fracture. Some of these complications, such as infection, loosening of the prosthesis and stiffness may require an additional surgery.

What is the average stay in the hospital after replacement?

Most patients are in the hospital after replacement for 2-3 days. Patients who live with someone who can assist them after surgery generally transition to home without much problem. Often time's home health and home physical therapy is utilized for the initial weeks at home. If a patient lives alone it is encouraged that they find someone who can stay with them when they return home. If the patient is not safe to go home or is not progressing well a rehabilitation facility may be used for 1-2 weeks until they can care for themselves independently.

How long will a sling need to be utilized?

Most patients use a sling for about 4 -6 weeks or until instructed otherwise by the surgeon.

How successful is Reverse Total Shoulder replacement surgery?

Results are generally very good; most people are relieved of their shoulder pain and the replaced joint will usually last ten or more years, depending on the patient use and activity levels.

The major long-term problem is loosening of the prosthesis. This occurs either because the artificial shoulder cement becomes loosened or because the bone melts away (reabsorbs) from the cement.

 

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