Reverse shoulder arthroplasty for complex shoulder osteoarthritis

Reverse shoulder arthroplasty has been used more frequently in patients with complex shoulder arthritis. This procedure is designed for patients who have severe arthritis and rotator cuff damage that has led to significant pain, weakness, and limited range of motion in the shoulder joint.

In a healthy shoulder joint, the ball-shaped end of the upper arm bone (humerus) fits into a shallow socket in the shoulder blade (scapula). The rotator cuff muscles and tendons hold the joint together and allow for a wide range of motion. In a reverse shoulder arthroplasty, the traditional ball-and-socket joint is replaced with a prosthetic device that reverses the position of the ball and socket components.

This reversed configuration of the joint allows the deltoid muscle to take over the function of the damaged rotator cuff muscles and tendons. This can provide significant pain relief and improve the patient’s ability to perform daily activities.

The procedure is performed under general anesthesia, and the surgeon makes an incision over the shoulder joint. The damaged bone and tissue are removed, and the prosthetic components are placed in the shoulder joint. The procedure typically takes two to three hours, and patients will need to stay in the hospital for a few days to monitor their recovery.

After the procedure, patients will need to undergo physical therapy to regain strength and range of motion in the shoulder joint. The length of time for recovery varies depending on the severity of the condition and the extent of the surgery.

Reverse shoulder arthroplasty is a safe and effective option for patients with complex shoulder arthritis who have not responded to non-surgical treatments such as physical therapy, NSAIDs, and corticosteroid injections.

If you are experiencing severe pain, weakness, and limited range of motion in your shoulder joint due to complex shoulder arthritis, I encourage you to reach out to our office or click here to discuss nonsurgical and surgical options.

Andrew

Total shoulder vs reverse shoulder replacement

As reverse shoulder replacements become more and more common, patients routinely come in asking about the difference between it and a standard total shoulder replacement. Here goes my explanation:

Anatomic Total Shoulder Arthroplasty:

An anatomic total shoulder arthroplasty, also known as a traditional shoulder replacement, involves replacing the ball-and-socket joint of the shoulder with a metal ball and a plastic socket. This procedure is typically performed when the patient has arthritis of the shoulder joint and has intact rotator cuff muscles.

During the procedure, the surgeon removes the damaged parts of the shoulder joint and replaces them with the artificial joint. The new joint is designed to replicate the natural movement of the shoulder, allowing the patient to regain a significant amount of mobility and function.

Reverse Total Shoulder Arthroplasty:

A reverse total shoulder arthroplasty, on the other hand, is a more recent innovation that was designed for patients with a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis. In these patients, the rotator cuff muscles are not functioning properly and cannot support the joint.

During a reverse shoulder replacement, the surgeon reverses the position of the ball and socket joint. This means that the ball is placed on the socket side of the joint and the socket is placed on the ball side of the joint. This changes the mechanics of the joint and allows the deltoid muscle to take over as the main muscle that powers the shoulder.

The purpose of the reverse shoulder replacement is to restore the patient's ability to lift the arm and perform activities of daily living. However, the range of motion may not be as good as with a traditional shoulder replacement.

In summary, anatomic total shoulder arthroplasty is best for patients who have arthritis of the shoulder joint and have intact rotator cuff muscles. A reverse total shoulder arthroplasty is best for patients who have a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis or significant deformity. Both procedures can help improve the patient's quality of life and restore function to the shoulder joint, but it is important to consult with your surgeon to determine which procedure is right for you.

As always, please feel free to contact my office with any questions.

Andrew

Subscapularis repair in reverse shoulder arthroplasty #ASES #Health

https://www.ncbi.nlm.nih.gov/pubmed/31743476?dopt=Abstract

Interesting article about the biomechanics of subscapularis repair during a reverse shoulder arthroplasty. I use a lateralized implant for many reasons, so this article is pertinent to my practice and patients. The article found that a superior repair lead to the least stress on the repair. A failed subscapular repair can lead to shoulder weakness after surgery, so a successful repair is important, although controversial. I will consider this technique in the future and I look forward to more articles on the this subject.