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Reverse Total Shoulder Replacement

Reverse total shoulder arthroplasty is an ideal treatment for shoulder dysfunction caused by rotator cuff tear arthropathy, a complex type of shoulder arthritis. Reverse total shoulder arthroplasty was originally developed because of unsatisfactory results from total shoulder replacement for people with degenerative shoulder conditions and fractures.

Today reverse total shoulder arthroplasty is frequently used to treat difficult diagnoses for patients who do not qualify for conventional/anatomic shoulder replacement surgery. It is a solution for patients with practically hopeless situations. These patients often have severe disability and are unable to raise their arm away from the side beyond ninety degrees (pseudoparalysis).

Pseudoparalysis is one of the most challenging conditions in shoulder surgery, caused by an irreparable massive rotator cuff tear. Reverse total shoulder replacement is a reliable procedure to reverse pseudoparalysis.

Who is a good candidate for reverse total shoulder replacement surgery?

This approach is for patients who have severe damage to the rotator cuff muscles.

  • Rotator Cuff Tear Arthropathy – severe shoulder arthritis with a total loss of rotator cuff function that destroys of the joint surfaces.
  • Severe shoulder pain and pseudoparalysis
  • Inflammatory arthritis (rheumatoid arthritis) with and without rotator cuff tears
  • Massive rotator cuff damage that is not repairable
  • A complex fracture of the shoulder joint often seen in the elderly
  • A failed previous shoulder replacement
  • A failed prior rotator cuff surgery
  • Chronic shoulder dislocation
  • Tumors in the shoulder joint

Reverse shoulder is appropriate for young and old patients. However, some patients may not be eligible including:

  • smokers
  • patients with osteoporosis
  • patients who do not have a well-functioning deltoid muscle
  • patients with systemic infections, poor wound healing or nerve damage in the shoulder, arm and hand

Complications are similar to those from a conventional shoulder replacement. Reverse shoulder replacement surgery is a salvage procedure when a patient has such challenging conditions that they are not a candidate for total shoulder replacement. Nevertheless, reverse total shoulder arthroplasty provides excellent pain relief, and restore range of motion.

Your orthopedic consolation

Dr. Godin will review your condition and potential treatment options including reverse shoulder replacement and possible complications. It is important to note that reverse shoulder has revolutionized the treatment of shoulder disorders that previously had no acceptable solution.

Patient satisfaction is high, and most patients experience pain relief and improved function.

About reverse total shoulder replacement

A conventional total shoulder replacement relies on a healthy rotator cuff to function properly and provide stability.  In a conventional shoulder replacement, the shoulder socket is lined with plastic and the top of the upper arm bone is replaced with a metal stem and ball.  In contrast, in a reverse total shoulder arthroplasty shoulder function and stability rely on the deltoid muscle and the ball and socket are reversed. The ball is attached to the shoulder blade and the socket is attached to the top of the arm bone.

Thus, this approach is perfect when the damaged shoulder needs new surfaces, but there is not enough healthy tissue to stabilize and move the shoulder. Reverse total shoulder arthroplasty is a successful, outpatient shoulder joint replacement surgery to relieve pain and improve function. Replacement parts typically last at least ten years.

Reverse total shoulder arthroplasty is a complex procedure that requires the highly technical skills of an expert shoulder specialist. Dr. Johnathan Godin is that expert. He and his team at Vail Orthopedic Surgery offer state of the art procedures and treatments that can get you back to the life you love and the activities that give life meaning. Contact him today to schedule a consultation at his Vail, Frisco and Edwards Colorado locations. There you will learn about all your treatment options.

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