At EmergeOrtho—Blue Ridge Region, we strive to treat most orthopedic conditions conservatively, using noninvasive methods and therapies. But when shoulder pain or mobility issues have not responded to nonoperative treatment approaches, your orthopedic surgeon may recommend a reverse shoulder replacement surgery. Our board-certified, fellowship-trained orthopedic specialists have successfully performed multiple reverse shoulder replacements, helping restore mobility, relieve pain, and improve the overall quality of life for our patients.

We are committed to fully educating our patients on our surgical procedures. Read on for more information on reverse shoulder replacement.

Anatomy of the Shoulder

The shoulder is made up of three bones: the scapula (shoulder blade), clavicle (collarbone), and humerus (upper arm bone). Two joints in the shoulder allow it to move: the acromioclavicular joint, where the highest point of the scapula (acromion) meets the clavicle, and the glenohumeral joint. At its core is the ball-and-socket configuration, where the humerus ball comes together with the scapula socket, supported by the rotator cuff for stability and movement.

Reverse Shoulder Replacement Surgery Procedure

A graphic of the anatomy of the shoulder.This shoulder surgery is an advanced method that basically reconstructs the shoulder’s natural architecture to restore function where the original parts have been damaged. Surgeons remove the damaged areas of the shoulder and replace them with artificial components, attaching a metal ball to the shoulder blade and placing a plastic socket on the upper arm bone.

The primary goal of reverse replacement is twofold: alleviate the pain that other more conservative treatments did not and restore joint function by allowing other muscles to take over for the damaged rotator cuff, improving arm movement. The procedure typically takes two hours and most patients can go home the same day, while others an overnight stay is typically sufficient.

Total Shoulder Replacement vs. Reverse Shoulder Replacement

Traditional total shoulder replacement has long been the standard for relieving degenerative shoulder conditions—especially in patients with intact rotator cuffs—by replicating the joint’s natural movements with artificial components. In total shoulder surgery, the metal ball attaches to the upper part of the humerus, and the new plastic socket attaches to the shoulder blade. This more closely follows a person’s real anatomy.

When traditional methods do not work, especially in the case of extensive rotator cuff damage, reverse shoulder replacement provides better outcomes. It has a unique advantage by enabling other muscles to provide mobility through a reversal of the joint’s structure. In a reverse replacement, the ball is placed on the socket side of the joint. This is the opposite of where it is located or the “reverse” of what you would expect. The socket is then placed on the arm side where it is supported by a metal stem in the arm bone (the humerus).

Recovery and Rehabilitation: Post-Surgery Care

Post-operative care is essential to getting the best outcome from reverse shoulder replacement. Following the surgery, managing pain and setting realistic expectations for recovery are paramount for both patients and their caregivers. Though recovery is different for each patient, generally recovery times are as follows:

  • Initial weeks: Focus on healing and gentle movements to prevent stiffness
  • 1-3 months: Gradual increase in physical therapy exercises to regain strength and mobility
  • Beyond 3 months: Continued improvement with the goal of returning to normal daily activities, though high-impact activities may still be restricted

After reverse shoulder replacement surgery, you will receive a personalized set of detailed instructions on dos and don’ts to prevent strain on the newly reconstructed shoulder. Your surgeon will provide a regimen of pain management, often involving nonsteroidal, anti-inflammatory drugs (NSAIDs) to reduce inflammation and provide comfort during the initial recovery phase. You will typically use a sling to support and protect the shoulder during the initial healing stage.

Your structured rehab plan is key to rebuilding strength and function over time safely and includes:

  • Physical therapy: A tailored physical therapy program is essential, often starting with passive exercises and advancing to more active movements as healing progresses.
  • Home exercises: Patients will learn a series of exercises to perform at home, contributing to their rehabilitation process.
  • Long-Term Care and Follow-Up: The path to full recovery does not finish with the end of formal physical therapy; it is an ongoing process requiring continued effort and regular follow-up with our orthopedic team.
  • Routine checkups: Monitoring the shoulder’s function and the integrity of the prosthetic components over time is crucial.
  • Activity modification: Patients may need to modify certain activities permanently to protect the longevity of the shoulder replacement.

By adhering to these postsurgical protocols and maintaining close communication with your surgeon and therapists, you can optimize your recovery and enjoy the full benefits of your reverse shoulder replacement.

At EmergeOrtho—Blue Ridge Region, we understand that shoulder pain and immobility can be debilitating and frustrating, impacting everyday home, work, and sports activities. Our shoulder subspecialists have treated thousands of patients with the most advanced nonsurgical and surgical methods. If you are struggling with shoulder pain, reverse shoulder replacement may be a good option for you.

Request an appointment with one of our shoulder specialists and Emerge Stronger. Healthier. Better.

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