Traditional Vs. Reverse Shoulder Replacement

Your shoulder joint is composed of four joints and three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone).  An edge of the scapula, called the acromion, forms the top of the shoulder. Your shoulder happens to encompass the most movable joints in your body, but can become unstable and the site of inflammation and injuries, such as sprains, strains, dislocations, separations, torn rotator cuffs, bursitis, tendonitis, frozen shoulder, fractures and arthritis.

In 2006, research showed approximately 7.5 million people went to the doctor’s office for a shoulder problem, including shoulder and upper arm sprains and strains. Shoulder injuries are frequently caused by athletic activities that involve excessive, repetitive, or overhead motion.

Most problems in the shoulder involve the muscles, ligaments, and tendons, rather than the bones. Arthritis, injury, and repetitive motions, such as those used during sports or work-related activities are leading causes of shoulder or elbow pain, stiffness, and restriction of movement. Athletes are especially susceptible to shoulder problems.  In athletes, shoulder problems can develop slowly through repetitive, intensive training routines. People also may underestimate the extent of their injury because steady pain, weakness in the arm, or limitation of joint motion will become almost second nature to them. There are two categories of shoulder injuries, instability and impingement.

What’s the difference between a standard total shoulder replacement and a reverse total shoulder replacement?

In standard total shoulder replacement surgery, a metal ball is used to replace the head of the humerus. A high-strength plastic implant is used to replace the socket of the shoulder blade.

In reverse total shoulder replacement surgery, the location of the new ball and socket are on the opposite sides of a normal shoulder. Their positions are “reversed.” A new metal hemisphere is used to replace the socket of the shoulder blade, and a metal and high-strength plastic socket is used to replace the head of the humerus.

Which surgery is best?

The primary goal of both approaches is to relieve pain. Secondary goals are to improve motion, strength, and function. Before any decision is made regarding the type of surgery, all nonsurgical options are approached first. Medications and physical therapy are tried first, and if the pain is still not significantly reduced, total shoulder replacement surgery is considered.

The degree of damage to the rotator cuff is one of the key factors in deciding which type of total shoulder replacement surgery is the better option. Although standard shoulder replacement surgery reduces or eliminates pain and improves function, success depends on the condition of the rotator cuff. The more intact the rotator cuff is, the better the outcome.

Reverse total shoulder replacement surgery is the best option for patients with severe arthritis and a large rotator cuff tear. Despite the large rotator cuff tear, the change in position of the joint improves shoulder function and replacing the joint removes any arthritis. More than 90 percent of patients experience significant improvement in both shoulder pain and function, including the ability to raise their arm overhead.

To find out more information on whether Standard Shoulder Replacement or Reverse Shoulder Replacement is right for you, call Spectrum Orthopaedics at (330)-305-0838 to request an appointment, or request an appointment online.

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