What's a Reverse Total Shoulder?

In the past 15 years, there has been a remarkable advance in the world of shoulder surgery in the form of a new type of shoulder replacement called a "reverse" total shoulder.  In surgery, it is rare that something truly new comes along.  The reverse shoulder replacement represents a real improvement in a surgeon's ability to treat severe shoulder problems.

A Diagram of a Reverse Shoulder Replacement
What's new about it?  Unlike a standard shoulder replacement, the ball and socket are completely reversed.  In a normal shoulder replacement I remove the ball and socket and replace them with a new metal ball and plastic socket.  In a reverse total shoulder,  the metal ball actually goes on the socket side of the shoulder and the plastic socket is placed on what used to be the ball side.  Because the ball and socket are now opposite from their normal position, they are "reversed"--thus the term "reverse shoulder replacement."

Why is it needed?  What's so great about it?   Before the reverse total shoulder, there was no good way to treat the combination of shoulder arthritis and severe rotator cuff tendon tear.  We could treat shoulder arthritis with a regular shoulder replacement.  We could treat a tendon tear with a tendon repair.  But the patient with both of these problems at once could not be effectively treated.  There was literally no good answer for someone with that combination of problems.  The reverse total shoulder replacement was developed to provide a solution to that problem, and so far it has proved enormously successful.

Reverse shoulder replacement is only appropriate for a small number of patients with a very specific set of problems.  In my shoulder practice, I perform about 30-40 reverse shoulder replacements a year. Like any surgery, there is a risk of complications, and any decision to proceed with a replacement should only be undertaken after a careful evaluation and discussion with your surgeon.

To read more about reverse shoulder replacement, the American Academy of Orthopedic Surgery has a nice summary for patients at http://orthoinfo.aaos.org/topic.cfm?topic=A00504


Abigayle said…
Good and helpful information. Thank you for sharing this to us. Thank you so much.