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Reverse Total Shoulder Replacement vs. Total Shoulder Replacement

For many people with painful shoulder arthritis, conventional total shoulder replacement is a beneficial treatment option. However, for a specific type of shoulder arthritis called cuff tear arthropathy, this type of surgery can result in more pain and limited motion. In this case, reverse total shoulder replacement might be a good option.

What is the difference between the two shoulder replacement options?

 In total shoulder replacement, a surgeon places a device that mimics the normal anatomy of the shoulder joint. A plastic cup fits inside the shoulder socket and a metal ball is attached to the humerus (upper arm bone). In a reverse total shoulder replacement, the cup and ball devices are switched, allowing different muscles to move the arm.

In a patient who has a rotator cuff tear or cuff tear arthropathy, the muscles that normally provide range of motion to the shoulder no longer function properly. Since total shoulder replacement relies on those muscle groups, this option can cause more harm. Reverse total shoulder replacement uses the deltoid muscle to take on the work of the damaged rotator cuff.

Who is a good candidate for reverse total shoulder replacement?

Patients who have:

- A complete tear in the rotator cuff

- Cuff tear arthropathy

- Had an unsuccessful shoulder replacement

- Severe shoulder pain and limited range of motion

- A complex fracture in the shoulder joint

- Tried other treatment options

Recovery after reverse total shoulder replacement

In most cases, patients return home after a few days in the hospital. A physical therapy program will most likely be recommended, which can last for several weeks. Like most other surgeries, it is important not to overdo.