Shoulder

Reverse Shoulder Replacement

Reverse shoulder replacement is an advanced surgical technique primarily used to treat patients suffering from rotator cuff tear arthropathy (RCTA), a condition where both shoulder arthritis and a rotator cuff tear are present. Unlike traditional shoulder replacement, reverse shoulder replacement repositions the ball and socket of the shoulder joint. The metal ball is fixed to the glenoid (shoulder socket), and the plastic cup is fixed to the humerus (upper arm bone). This design relies on the deltoid muscle instead of the rotator cuff to move the arm, making it particularly effective for patients with rotator cuff issues.

When is Reverse Shoulder Replacement Recommended?

Reverse shoulder replacement may be recommended for the following conditions:

  • Completely torn rotator cuff that is difficult to repair
  • Cuff tear arthropathy: A condition where a torn rotator cuff leads to wear and tear of the shoulder joint, eventually causing arthritis
  • Previous unsuccessful shoulder replacement
  • Severe shoulder pain and difficulty with overhead activities
  • Chronic pain despite non-surgical treatments such as rest, medication, cortisone injections, and physical therapy


Benefits of Reverse Shoulder Replacement

  • Pain Relief: Significant pain reduction, especially in patients with severe rotator cuff tears and arthritis.
  • Improved Functionality: Restores functional mobility of the shoulder, allowing patients to perform everyday activities more easily.
  • Reliable Outcomes: In patients with rotator cuff arthropathy, reverse shoulder replacement has proven to be highly effective in alleviating pain and improving shoulder function .

Procedure for Reverse Shoulder Replacement

The procedure for reverse shoulder replacement involves several important steps:

  1. Incision and Exposure: A surgical incision is made over the affected shoulder to expose the joint.
  2. Dislocation of the Humerus: The humerus is dislocated to separate it from the glenoid socket of the scapula (shoulder blade).
  3. Removal of Damaged Parts: The arthritic portions of the humeral head (ball) and glenoid socket are removed and prepared for the insertion of the artificial components.
  4. Insertion of Artificial Components: The metal ball is screwed into the glenoid (socket), and the plastic cup is cemented into the humeral bone.
  5. Fixation and Closure: The components are fixed securely in place, and the joint capsule is stitched back together. The soft tissues are approximated, and the wound is closed.

Recovery After Reverse Shoulder Replacement

The recovery process after a reverse shoulder replacement involves several stages, including pain management, physical therapy, and gradual return to normal activities.


Pain Management

During the initial recovery period:

  • Pain Relief: Patients are typically given pain relief medications such as paracetamol and anti-inflammatory drugs. Stronger medications may be prescribed in the early stages but are phased out as recovery progresses.
  • Ice Therapy: Applying ice packs to the shoulder for 20 minutes, 3–4 times a day, helps reduce swelling and manage pain.

Physical Therapy

Rehabilitation is crucial for a successful recovery:

  • Post-Operative Rehab: A tailored physical therapy program will be provided to improve range of motion and strength of the shoulder. This will help patients regain mobility and function.
  • Follow-Up Exercises: Regular exercises will be prescribed to prevent stiffness and improve muscle strength, focusing on the deltoid and surrounding shoulder muscles.

Return to Work and Sports

  • Return to Work: Recovery time will vary depending on the physical demands of your work. Most patients should plan for at least two weeks off work for initial recovery. If your work is physically demanding, involving heavy lifting or overhead movements, returning to full duties may take 6 to 12 weeks.
  • Return to Sports: For sports activities, especially high-impact or overhead sports, a return to normal activity typically takes between 3 to 6 months after surgery. Dr. du Sart will assess your recovery and advise on when it is safe to resume full sports participation.

Driving

  • Patients should avoid driving for at least 6 weeks or until the sling is removed. Full mobility and strength must be regained before it is safe to drive again. Discuss any concerns regarding driving with Dr. du Sart during your post-op check.


Why Choose Dr. Ryan du Sart for Reverse Shoulder Replacement?

Dr. Ryan du Sart is a highly trained orthopaedic surgeon with extensive experience in performing reverse shoulder replacement surgeries. His approach is patient-centred, ensuring that each individual receives the most effective and tailored care to achieve the best outcomes. Dr. du Sart uses advanced surgical techniques and state-of-the-art prosthetic components to ensure long-term success.


Book a Consultation

If you are suffering from shoulder pain due to rotator cuff tear arthropathy or arthritis and have been considering shoulder replacement surgery, early intervention can make a significant difference. Contact Dr. du Sart for a consultation to discuss your options for a reverse shoulder replacement and how it can improve your quality of life.

Phone: (08) 9779 9767
Email: admin@ryandusart.com.au

Clinic Locations:

6 Higgins Street, South Bunbury, WA 6230

20 Prince Street, Busselton, WA 6280



References:

  1. Griffiths, T. (2018). "Clinical Outcomes and Benefits of Reverse Shoulder Arthroplasty for Cuff Tear Arthropathy." Orthopedic Clinics of North America, 49(1), 123-130.
  2. Poirier, A., & Martin, S. (2020). "Reverse Shoulder Arthroplasty: The Rationale and Results." Journal of Shoulder and Elbow Surgery, 29(5), 917-924.
  3. Sullivan, D., & McFarland, E. (2019). "Innovations in Reverse Shoulder Arthroplasty." Orthopedic Reviews, 11(2), 45-50.