Choosing Reverse Shoulder Replacement

A person who has painful shoulder arthritis and a damaged rotator cuff may be advised to consider reverse shoulder replacement. During this surgery a surgeon switches—or reverses—the positions of a shoulder joint’s ball and socket:

• The ball at the top of the humerus (upper arm bone) is replaced with a socket-shaped prosthetic
• The shoulder’s natural socket is fitted with a prosthetic ball

Switching the position of the ball and socket changes the biomechanics of the shoulder’s rotation. The new shoulder relies on the deltoid muscle, located at the top of the shoulder, to compensate for a weak rotator cuff.

Most people who undergo reverse shoulder replacement report:

• Less pain
• Increased shoulder strength
• Better range of motion

While it has potential advantages, reverse shoulder replacement surgery cannot repair or replace the damaged rotator cuff. Patients are advised to avoid putting significant stress on the shoulder joint after surgery. For example, many patients may be able to rake leaves and swim after the procedure, but not shovel heavy snow or play tennis.

See Deciding on Shoulder Replacement Surgery

Talk to a Doctor About Reverse Shoulder Replacement
A doctor and patient can talk about the existing joint damage on the painful shoulder as well as the patient’s lifestyle, hopes and expectations, and potential surgical risks. The doctor will also ask the patient questions and perform a physical exam to decide whether or not the patient is healthy enough to undergo surgery.

Learn more: Who Gets Reverse Shoulder Replacement?

Traditional Shoulder Replacement
Reverse shoulder replacement surgery is an alternative to a traditional shoulder replacement, which requires a healthy rotator cuff. The positions of the shoulder’s ball and socket stay the same in traditional shoulder replacement. Because a new shoulder’s biomechanics mimic that of a natural shoulder, there are fewer post-surgical activity limitations for people who undergo traditional total shoulder replacement.¹Katz JN, Earp BE, Gomoll AH. Surgical management of osteoarthritis. Arthritis Care Res (Hoboken). 2010 Sep;62(9):1220-8. doi: 10.1002/acr.20231. Review. PubMed PMID: 20506552; PubMed Central PMCID: PMC2942971.

Learn more about Total Shoulder Replacement Surgery