Reverse Total Shoulder Replacement

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What is Reverse Total Shoulder Replacement?

In conventional Total Shoulder Replacement, the normal anatomy of the shoulder joint is copied; to replace the shoulder socket, a plastic cup is fitted to the shoulder bone and to replace the ball or top of the upper arm bone (Humerus), a metal ball is attached to the Humerus. However, in a Reverse Total Shoulder Replacement, also known as Reverse Total Shoulder Arthroplasty (RTSA), the placement of the metal ball and the plastic cup is switched. The metal ball is attached to the shoulder bone, and the plastic cup is fixed to the upper arm bone.

 

RTSA was first performed in Europe in 1987 and the USA in 2004. It was approved by the US FDA (Food and Drug Administration) in 2004, and since then, the number of RTSA performed annually has been growing exponentially.

reverse total shoulder replacement surgery boise

When is Reverse Total Shoulder Replacement Recommended?

Reverse Total Shoulder Replacement surgery is most commonly recommended by an orthopedic surgeon to patients who have Rotator Cuff Tear Arthropathy (Arthritis along with large cuff defect). However, RTSA is also recommended for several other conditions that are difficult to treat with conventional total shoulder replacement surgery, like:

  • A completely torn Rotator Cuff that cannot be repaired
  • Failed shoulder replacement surgery
  • Acute fracture of the proximal humerus
  • A complex fracture of the shoulder
  • Malunited/nonunited proximal humerus fracture
  • Tumor of the shoulder joint
  • Chronic locked shoulder dislocation
  • Chronic pseudoparalysis caused due to irreparable rotator cuff without arthritis
  • Immunological arthritis with or without associated rotator cuff tears
  • Arthritis of shoulder with severe Glenoid bone loss
  • Severe and persistent shoulder pain and difficulty lifting arm
shoulder replacement surgery

How do you prepare for Reverse Total Shoulder Replacement?

You will be advised to have a complete physical examination done by your primary care doctor before the surgery. If you have any long-standing medical condition like heart disease or diabetes, then you must consult a specialist before the surgery. You should also inform your surgeon about the medications you are taking. The surgeon might ask you to discontinue certain drugs 2-3 weeks before the surgery like aspirin, ibuprofen or certain arthritis medicines.

What Happens During Reverse Total Shoulder Replacement?

Before the surgery, your anesthetist and the surgeon will explain to you about the type of anesthesia being used. After giving anesthesia, your surgeon will make an incision on the shoulder. The damaged tissue and bone is removed from the joint and an artificial joint is fixed to restore the shoulder movement. The entire procedure takes around 2-3 hours.

total shoulder replacement procedure

What to Expect for Recovery from Reverse Total Shoulder Replacement Surgery

After the surgery, you are administered antibiotics and pain-killers through the IV line to reduce the pain and risk of infection. Usually, the patient stays in the hospital for 1-2 days after the surgery. Some may even go home the same day. Most patients can get out of bed and eat solid food the day after surgery. Before you are discharged, your arm will be supported by a sling. Your doctor will advise you to do some gentle exercises to improve blood circulation and healing. You should be able to do your daily activities yourself within a few weeks after surgery. The doctor will advise regular physical therapy to regain the strength and flexibility of the shoulder joint.

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Ryan Applonie, DO has a passion for helping others. Our staff has a combined 50+ years of orthopedic excellence dedicated to the people of the Boise area. All of our surgeons are board certified by the American Board of Orthopaedic Surgery.

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