There are two main types of shoulder replacement each with unique indications. The anatomic total shoulder replacement is used for arthritic shoulders when the rotator cuff is intact. The joint surfaces can be replaced while preserving the rotator cuff to allow pain free motion. It is often used in younger patients. The surgery takes approximately 1 hour. It can be performed outpatient or with staying in the hospital overnight. Patients are protected in an immobilizer for 6 weeks after surgery. Physical therapy is started approximately 3-4 weeks after surgery.
The reverse shoulder replacement is used most commonly for rotator cuff tear arthropathy as well as significant fractures of the proximal humerus. The rotator cuff functions to hold the “ball” securely on the socket. In situations where the rotator cuff is torn, there is destabilization of the ball on the socket and patients can have severely impaired ROM. In its chronic state, the joint can become very arthritic. In this situation, we will use a reverse shoulder replacement to change the biomechanics of the shoulder. We place the ball on the socket side thereby reversing the shoulder. This allows us the opportunity to retrain the deltoid muscle and allow a much improved range of motion profile to the shoulder.
The surgery takes approximately 1 hour. Most patients that require a reverse shoulder arthroplasty will stay in the hospital overnight and be discharged home the following day. Patients are protected in an immobilizer for 6 weeks after surgery. Physical therapy is started approximately 3-4 weeks after surgery.
With either an anatomic or reverse shoulder arthroplasty, risks of surgery are present. Risks of shoulder arthroplasty include but are not limited to postoperative infections, loosening, dislocation, fracture, or wear.