Who’s a Good Candidate For a Reverse Shoulder Replacement?

Around 2 million patients visit a doctor each year for a torn rotator cuff, one of the primary reasons for a reverse shoulder replacement. If you suffer from this type of injury, or several others, a reverse shoulder replacement may actually work better than standard shoulder replacement surgery.

Sports medicine doctor and orthopedic surgeon Robert A. Mileski, MD, treats patients using standard shoulder and reverse shoulder replacement, and myriad other treatments, at Phoenix Orthopedic Group in Scottsdale, Arizona.

Standard vs. reverse shoulder replacement

During standard shoulder replacement surgery, Dr. Mileski attaches a metal ball to your upper arm bone, known as the humerus, and a plastic socket to your shoulder blade, which mimics our anatomy. Depending upon the nature of your injury, reverse shoulder replacement may be a better solution. In the latter, Dr. Mileski reverses the placement of the ball and socket.

Best candidates for reverse shoulder replacement

A standard shoulder replacement requires stable tendons and muscles in the shoulder area. If you’ve suffered a rotator cuff injury, however, these may be torn, causing pain and restricting your movement. Dr. Mileski may instead implement a reverse shoulder replacement to improve your condition.

Other disorders may also warrant reverse shoulder replacement surgery, such as:

Arthritis of the shoulder

When you suffer from a form of arthritis known as cuff tear arthropathy and your shoulder joint and/or rotator cuff tendons no longer work properly, a reverse shoulder replacement may restore motion and reduce pain.

Fractures

Patients with shoulder fractures that include a broken humeral ball or humerus may benefit.

Chronic shoulder dislocation

Recurrent dislocations may be due to a variety of causes, such as:

• Repetitive strain
• Anatomical variations
• Torn ligaments
• Soft tissue injuries

These often lead to pain, swelling, and lack of mobility in your arm, which may be healed through this type of surgery.

Unsuccessful standard shoulder replacement

If you’ve already undergone standard shoulder replacement without success, reverse shoulder replacement surgery may be the answer for unresolved issues of pain and/or movement.

In studies performed overseas, 85-90% of patients reported pain relief following their reverse shoulder replacements.

What happens during surgery?

After checking your temperature, blood pressure, oxygenation levels, and heart rate, an anesthesiologist administers general, regional, or a combination of anesthesia. Dr. Mileski then:

• Creates an incision to access your shoulder joint
• Disconnects the humeral ball from the socket
• Replaces all or a section of your shoulder joint with artificial elements

Following surgery, you remain in recovery until you wake, then head to a hospital room for a day or two. You’ll then wear a sling for several weeks.  

A sign it’s time

You may want to consider surgery if you continually suffer from pain or stiffness while performing everyday tasks that require lifting your arms, even after trying less invasive treatments, including:

• Physical therapy
• Cortisone injections
• Platelet-rich plasma (PRP)
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

Dr. Mileski recommends these, as well as standard and reverse shoulder replacement surgery, to help relieve your pain and regain mobility.

If you’re experiencing a shoulder injury or wish to discuss other orthopedic issues, from joint pain to arthritis, schedule a consultation with Dr. Mileski at Phoenix Orthopedic Group today.