Reverse total shoulder replacement, also called reverse shoulder arthroplasty, is a surgical procedure that aims to enhance shoulder function and decrease pain in patients with end-stage shoulder arthritis or other conditions where the rotator cuff muscles are compromised or unavailable. Here’s an overview:

Indications

·        Rotator cuff tear arthropathy: A subtype of shoulder arthritis that is linked to a large rotator cuff tear.

·        Failed previous shoulder surgeries: Previous traditional shoulder replacements or rotator cuff repairs are also allowed.

·        Severe shoulder fractures: Especially in geriatric patients with multiple comorbidities and polytrauma.

·        Chronic shoulder dislocations: Resulting to instability and damage.

·        Certain types of shoulder arthritis: Where the rotator cuff is damaged.

Procedure

In a reverse total shoulder replacement, the normal ball-and-socket structure of the shoulder joint is reversed:In a reverse total shoulder replacement, the normal ball-and-socket structure of the shoulder joint is reversed:

·        Glenoid (socket) component: A ball shaped implant is fixed on the shoulder blade (scapula).

·        Humeral (arm bone) component: A cup-shaped prosthesis is secured to the top of the upper arm bone (humerus).

Benefits

·        Improved shoulder stability: Thus, shifting the center of rotation, the deltoid muscle can help to overcome the defects of the rotator cuff muscle.

·        Pain relief: A great deal of relief from shoulder arthritis or rotator cuff tears pain.

·        Enhanced range of motion: Enhanced flexibility and range of motion of the shoulder joint.

Risks and Complications

·        Infection: With any surgery, there is always a possibility of infection.

·        Dislocation: It can become dislocated, although this is not very likely in the case of reverse total knee arthroplasty when compared to the standard one.

·        Fractures: Fracture at the site of the implants.

·        Nerve damage: Risk of injury to the nerves in the shoulder area.

·        Loosening of implants: Eventually, some of the parts may become loose and the patient may require another surgery.

Recovery and Rehabilitation

·        Hospital stay: Usually within a few days after surgery.

·        Immobilization: The first phase of treatment involves using a sling to restrict movement of the shoulder.

·        Physical therapy: To help the patient recover strength and flexibility, the treatment should begin with passive exercises followed by active ones.

·        Full recovery: It can take several months and the results can be seen for up to one year.

Outcomes

·        Pain relief: The majority of patients report a decrease in pain levels.

·        Function improvement: Improved capability to carry out regular tasks.

·        Longevity of the implant: Usually, the implants can last for several years; however, the activity level, general health, and compliance with the recommended rehabilitation can affect their lifespan.

Reverse total shoulder replacement is a useful procedure for patients with difficult shoulder problems, giving them an opportunity to restore function and increase their quality of life when other measures have been ineffective.