Reverse Total Shoulder Arthroplasty Denver
What is a Reverse Total Shoulder Replacement?
In a patient that has shoulder arthritis and an irreparable rotator cuff tear or cuff tear arthropathy, a traditional total shoulder replacement can leave them with continued pain and limited range of motion because the rotator cuff insufficiency is not improved with the surgery. The better option for this type of patient is a reverse total shoulder replacement because the ball and socket components are switched and this design allows the deltoid muscle to lift the arm since the rotator cuff muscles are unable to do so effectively.
In a reverse total shoulder replacement, the glenoid (shoulder blade) component consists of a metal plate that is anchored in the bone with screws and a metal ball that is attached to the plate. The humerus (upper arm bone) portion of the prosthesis is composed of a plastic liner that locks into a metal stem creating the socket that articulates with the metal ball on the glenoid. The metal stem is implanted in the top of the humerus bone and the component is either cemented in place or impacted (press-fit) in the bone. Patients that have had a previous unsuccessful traditional total shoulder replacement may also benefit from converting the joint replacement to a reverse total shoulder arthroplasty.
What Can I Expect after Surgery?
Most shoulder replacement patients will spend one to two nights in the hospital to work on gentle range of motion with a physical therapist, activities of daily living (dressing, showering, etc) with an occupational therapist, and to find an adequate pain medication regimen. The majority of shoulder replacement patients go home after leaving the hospital but some require a short stay at a rehabilitation facility if they will not have enough support at home after discharge. Case managers evaluate each patient’s situation and will arrange any home care that may be necessary.
Most surgeons will have their patients wear a sling for at least the first few weeks after surgery. The incision is typically in the front of the shoulder and is usually around six to eight inches long. Based on the nature of joint replacement surgery, most patients experience a moderate amount of bruising and swelling of their surgical arm and occasionally the chest. Every patient has a different pain tolerance after surgery but almost everyone requires pain medication for at least the first few weeks postoperatively. The first follow-up appointment in the surgeon’s office is typically seven to ten days after the surgery.
What is the Rehabilitation After Reverse Shoulder Replacement Surgery?
A structured rehabilitation program is crucial for any total shoulder replacement surgery to be successful. Most shoulder surgeons have their preferred postoperative physical therapy regimen but each rehabilitation program is designed and adjusted based on the patient’s unique physical ability, surgery performed, and progress throughout the program. The rehabilitation programs for traditional, reverse, and partial total shoulder replacements typically follow the same general protocol with gentle range of motion beginning the day after surgery. More aggressive physical therapy is added several weeks after surgery and most patients will continue with therapy for three or more months postoperatively.
How Long Does a Shoulder Replacement Last?
With advances in surgical techniques and shoulder implants, a shoulder replacement may provide 15-20 years or more of functional life and pain relief.