Reverse Total Shoulder Replacement
Reverse Total Shoulder Replacement Surgeon
Are you suffering from severe shoulder arthritis? If so, you may be a candidate for a reverse shoulder replacement. Reverse shoulder replacement may be recommended in patients who have developed a complex type of shoulder arthritis called “rotator cuff tear arthropathy.” Reverse shoulder replacement surgeon, Dr. Nikhil Verma provides diagnosis and both surgical and nonsurgical treatment options for patients in Chicago who have developed severe shoulder arthritis. Contact Dr. Verma’s team today!
An Overview on Reverse Shoulder Replacement
Shoulder arthritis causes pain, swelling and inflammation and is quite common in the older adult population. Arthritis can develop from a previous shoulder injury or from natural wear and tear and aging of the joint. When the cartilage of the ball and socket begins to wear away, conservative measures such as rest, ice and anti-inflammatory medications can alleviate the symptoms. In some cases, along with cartilage deterioration, the rotator cuff may tear or become dysfunctional. Alternatively, fractures or prior surgery can cause significant deformity of the normal anatomy and functional deficits. If the condition progresses and all other treatment options fail, a reverse shoulder replacement may be recommended by Dr. Nikhil Verma, shoulder surgeon serving the communities of Chicago, Westchester, Oak Brook and Hinsdale, Illinois.
Reverse shoulder replacement may be a recommended shoulder treatment for patients who have developed a complex type of shoulder arthritis called “rotator cuff tear arthropathy.” This condition occurs when the muscles that help center the ball (humeral head) in the socket (glenoid part of the shoulder blade) move higher than the socket because of long standing rotator cuff tears. A rotator cuff tear that cannot be repaired and a failed total shoulder replacement are additional shoulder injuries that can be effectively treated by this procedure.
A traditional shoulder replacement depends on the rotator cuff muscles to keep the replacement in position and allow shoulder movement. When a patient experiences a rotator cuff tear that cannot be repaired or if the rotator cuff muscles no longer function like they should, a reverse shoulder replacement may be the best treatment option since it relies on the deltoid muscle to create movement.
A reverse shoulder replacement is much like a traditional shoulder replacement. Both techniques involve replacing the natural degenerated bone and cartilage with plastic and metal components. The components allow the shoulder to move freely and pain free. This special type of replacement surgery changes the biomechanics of the shoulder by allowing the deltoid muscle to stabilize and move the shoulder joint instead of the original rotator cuff muscles. Dr. Verma accomplishes this by placing the ball on the glenoid (typically the socket) and the socket on the humerus (typically the ball). With the reversal of the ball and socket, a “reverse” shoulder replacement is achieved.
The procedure is approximately one to two hours and generally requires an overnight hospital stay. It is performed through a small open incision in the front of the shoulder. The implant is generally fixed in place with screws on the socket side and impacted into the canal of the bone on the humeral side. This allows provisional fixation until the bone heals to the implant resulting in long term stability.
Reverse Shoulder Replacement Recovery
Following surgery, Dr. Verma’s team will provide the recommended amount of pain medication and antibiotics to alleviate pain and prevent infection. The arm will be placed in a sling for a predetermined amount of time. Physical therapy will begin almost immediately after the procedure. The initial therapy focuses on safe motion with certain restrictions for a specific amount of time, typically six weeks. Reverse shoulder replacement recovery is dependent on how closely a patient follows recovery guidelines. Many patients can expect a full recovery within three to four months.
For additional resources on injuries associated with osteoarthritis of the shoulder, or to learn more about reverse shoulder replacement, please contact the office of Dr. Nikhil Verma, orthopedic shoulder surgeon treating patients in the Chicago, Westchester, Oak Brook and Hinsdale, Illinois area.
What is the difference between a total shoulder replacement and reverse shoulder replacement?
A traditional shoulder replacement surgery depends on the rotator cuff muscles to keep the replacement components in place and provide movement, and is typically reserved for shoulder arthritis patients. A reverse shoulder replacement depends on the deltoid muscle for mobility and stability. A reverse procedure is effective in many patients with rotator cuff tear arthropathy, which is a rotator cuff tear that cannot be repaired and a failed shoulder replacement surgery.
How long does it take to recover from reverse shoulder replacement?
After a recovery period of approximately 6 months, patients are typically able to get back to their daily activities and note significant improvements in pain and overall joint function.
What recovery exercises should I do after a reverse total replacement?
Following reverse shoulder replacement, it is critical patients follow rehabilitation closely as prescribed by Dr. Verma. Physical therapy will begin immediately after surgery with a simple set of exercises to be continued at home. The arm is kept in a sling for approximately six weeks with full recovery in about 6 months.
When can I drive after a reverse shoulder replacement?
Driving is only recommended after regaining normal motion and strength in the shoulder. Most patients will be able to go home the same day, although in some cases an overnight stay is recommended if a patient has other medical conditions. Patients often require assistance for about six weeks after surgery and can usually drive normally in about 2 months.
What are my limitations after a reverse shoulder replacement?
Short term, patients are not allowed to drive, lift heavy objects, or rotate the arm and shoulder without help. After a carefully planned program of physical therapy, patients should be able to return to normal activities. Heavy weights should be avoided for 4-6 months however and some sporting activities may be limited the first year, such as watersking, downhill skiing or sports with a high fall potential.
Is a reverse total shoulder replacement painful?
Immediately following surgery, patients experience pain and discomfort. Pain can be managed with prescription pain medication, taken as prescribed by Dr. Verma. After rehabilitation and complete healing, patients have been shown to have little or no pain from reverse total shoulder replacement.
How successful are reverse total shoulder replacements?
A recent study found that patients undergoing reverse total shoulder replacement had an 85 percent rate of return to one or more sporting activities, approximately 5 months after surgery. Some active patients even started new sports post-surgery. Age was a significant predictor of a higher rate of return to sports for patients under 70.
For more information on Reverse Total Shoulder Arthroplasty Replacement Surgery, please contact the office of Dr. Nikhil Verma, orthopedic shoulder surgeon treating patients in the Chicago, Westchester, Oak Brook and Hinsdale, Illinois area.