Shoulder arthritis can cause significant damage to the bones in a shoulder joint. A reverse shoulder replacement is used to replace the damaged joint when rotator cuff tears or significant deformities to the joint prevent the use of a conventional “anatomic” shoulder replacement.
Dr. Wame Waggenspack is an expert at treating shoulder conditions. Feel free to book a consultation with him in Houston, Texas, today!
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Reverse shoulder replacement is a procedure used to replace a shoulder joint. The way the replacement works is in reverse to a conventional, or anatomic, total shoulder replacement.
A total shoulder replacement mimics the normal function of a shoulder joint. A meta implant is placed in the humerus (upper arm bone), and a plastic piece is fitted on the shoulder socket (glenoid).
With a reverse shoulder replacement, the plastic cup and metal ball are in a switched position. The plastic cup is fitted to the upper arm bone, and the metal ball is attached to the shoulder socket (glenoid).
A reverse total shoulder replacement works differently from a conventional shoulder replacement. With a conventional shoulder replacement, the rotator cuff muscles help to move the shoulder through the range of motion and give power to shoulder movements. This is similar to how a healthy shoulder works.
Reverse shoulder replacements rely on the deltoid muscle instead of the rotator cuff to move and power the arm. The implant converts the linear force of the deltoid muscle to a rotational force through the metal ball, which allows patients to lift their arm. This makes it the optimal treatment for those with torn rotator cuff tendons or rotator cuff tear arthropathy.
You may be a candidate for reverse shoulder replacement surgery if you have:
Dr. Waggenspack will try non-surgical treatments, such as rest, medications, cortisone injections, and/or physical therapy first. If these have not relieved your shoulder pain, then he may recommend reverse shoulder replacement surgery.
The reverse shoulder replacement procedure is an open surgical procedure where your surgeon will need to make an incision to access the joint. Your surgeon will first remove the damaged bone before replacing the joint with the replacement components.
Once your shoulder surgery is finished, you will be transferred to a room to recover from the general anesthesia. Most patients stay overnight and return home the next day, although patients with significant health problems or limited mobility may require longer stays or inpatient rehabilitation.
Some patients are able to go home the same day in certain circumstances. Dr. Waggenspack will discuss these expectations and possibilities at your preoperative clinic appointment.
You will be given medication to prevent infection, as well as multiple medications to reduce pain, called multi-modal pain management. The goal is to utilize multiple different medications to reduce the pain while using less narcotic pain medication.
Your arm must be supported by a sling during the initial phase of recovery, the first 6 weeks after surgery. Additionally, physical therapy will be prescribed at your first visit with Dr. Waggenspack after surgery, to help strengthen the joint and work on your range of motion. This will help you regain as much function as possible. Most patients are in therapy for several months, depending on how quickly they are able to regain
You can expect to return to some daily activities—such as eating, dressing, and grooming—within a few days or weeks after surgery. Returning to sports, working out, and other higher-demand activities will take several months.
The full healing process, including regaining motion, function, and strength, will continue for up to a year after surgery. You will see Dr. Waggenspack multiple times during this period to monitor your progress.
Your surgeon will make a personalized analysis to see whether a reverse shoulder replacement is suitable for your condition. The surgical risks of a reverse shoulder replacement could include pain, instability (dislocation), bleeding, infection, or nerve damage. Some complications can be successfully treated without additional surgery, although some may require an additional surgery, called a revision.
If you are careful to follow the instructions and treatment recommended by Dr. Waggenspack, you should expect an excellent outcome. Most patients have little to no pain on a daily basis and can return to as active a lifestyle as they prefer.
After you have recovered from the surgery, you will likely be able to lift your arm at least high enough to reach into a cabinet, although most patients are able to get their arm completely overhead. Rotational motion, which includes reaching out to the side or behind your back, is more unpredictable, although most people can get their hand to the back pocket or the small of the back.
Dr. Waggenspack understands the impact shoulder pain and limited mobility can have on your life. Our office is committed to providing cutting-edge solutions like reverse shoulder replacement surgery. With the expertise and personalized care provided by Dr. Waggenspack, we aim to help you rediscover comfort, mobility, and an active lifestyle.
Ready to regain your shoulder function and freedom from pain? Contact us for a consultation. Our office can be found in Houston, TX.
Medically reviewed by Dr. Wame Waggenspack
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