What is reverse shoulder arthroplasty?
Reverse shoulder arthroplasty
Reverse shoulder arthroplasty, another term for reverse shoulder replacement, addresses shoulder joint problems that a standard primary total shoulder replacement can’t. It’s called reverse because instead of re-creating the ball-and-socket joint in which the top of the arm bone (humerus) serves as the ball that fits into the socket of the shoulder (glenoid), the socket is created at the top of the humerus and the ball is anchored into what had been the shoulder socket. In situations where a primary shoulder replacement cannot sufficiently address your shoulder injury, your doctor may recommend a reverse shoulder arthroplasty to help reduce pain and restore some of the motion you’ve lost.2
For more than 30 years, doctors have studied the benefits of reverse shoulder arthroplasty. Stryker offers multiple solutions for reverse shoulder replacement. Stryker designed the ReUnion RSA (reverse shoulder arthroplasty) as an alternative for cases where rotator cuff muscles may be weak or have torn, and total shoulder arthroplasty may not be a sufficient solution. Stryker also offers Tornier Flex with a convertible short stem, which provide more options when planning for reverse shoulder replacement.
Advances in technology continue to influence the tools available to orthopaedic surgeons. In fact, doctors can now plan reverse shoulder replacement surgery with Stryker’s proprietary Blueprint software to match the implant and surgical specifics to the patient. For use with Blueprint, Stryker designed the Shoulder iD Primary Reversed Glenoid to replace the shoulder joint in order to relieve pain and to improve mobility. With Shoulder iD, the orthopaedic surgeon can perform a “virtual” shoulder replacement before the actual surgery using Blueprint and the patient’s CT scan images. Blueprint allows the surgeon to visualize the patient’s native shoulder anatomy in a three-dimensional space; in that virtual space, the surgeon can plan the size and position of the implant materials and make provisions for the unique anatomy of the patient.
Learn more about implant solutions
What happens during the actual procedure?
Similar to the procedure for primary total shoulder replacement, the surgeon makes an incision to expose the top (head) of the humerus and uses a cutting guide and preoperative plan to determine the appropriate amount of diseased bone to remove. Once prepared, the humerus is ready to be fitted for a stem inserted into the bone. The surgeon will then prepare the shoulder socket, securing a round plate to the bone with multiple screws.2 The surgeon fits a spherical shaped component onto the plate. A new socket placed on the arm bone completes the surgery.
After rehabilitation, you may be able to lift your arm to just above shoulder height and bend your elbow to reach the top of your head or into a cupboard. Reverse total shoulder replacement has been shown to offer pain relief and patient satisfaction.2
References:
- The Center for Disease Control and Prevention. Arthritis. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/arthritis.htm
- American Academy of Orthopaedic Surgeons. Treatment: Shoulder joint replacement. OrthoInfo. orthoinfo.org/en/treatment/shoulder-joint-replacement.
Shoulder replacement
Anatomic total shoulder joint replacement is intended for use in individuals with painful, disabling joint disease of the shoulder resulting from: degenerative arthritis, rheumatoid arthritis or post-traumatic arthritis. Additional indications could include but not limited to: aseptic necrosis of the humeral head, proximal humeral fracture and revision of previous unsuccessful hemiarthroplasty or other procedures.
Reverse total shoulder joint replacement is intended for use in individuals with a functional deltoid muscle and with massive and non-repairable rotator cuff tear with pain disabled by: rheumatoid arthritis, non-inflammatory degenerative joint disease, humeral head fracture, traumatic arthritis and revision of devices if adequate bone stock remains.
Shoulder joint replacement surgery is not appropriate for patients with any active or suspected latent infection in or about the shoulder joint, any mental or neuromuscular disorder which would create an unacceptable risk of prosthesis in stability, prosthesis fixation failure or complications in postoperative care. Additionally, shoulder joint replacement surgery is not appropriate for patients whose anticipated activities would impose high stresses on the prosthesis and its fixation.
As with any surgery, shoulder joint replacement surgery has serious risks which include, but are not limited to, pain, infection, intraoperative complications, component wear, nerve damage, loosening of shoulder components and dislocation of the shoulder prosthesis.
Implant related risks which may lead to a revision or removal of the implant include being overweight, manual labor activities, some sports activities, patient age, activity level, medical conditions, alcohol or drug addiction, and mental disorders. Shoulder joint implants may not provide the same feel or performance characteristics experienced with a normal healthy joint
The information presented is for educational purposes only. Speak to your doctor to decide if joint replacement surgery is appropriate for you. Individual results vary and not all patients will return to the same activity level. The lifetime of any joint replacement is limited and depends on several factors like patient weight and activity level. Your doctor will counsel you about strategies to potentially prolong the lifetime of the device, including avoiding high-impact activities, as well as maintaining a healthy weight. It is important to closely follow your doctor’s instructions regarding post-surgery activity, treatment, and follow-up care. Ask your doctor if a joint replacement is right for you.
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OT-AWI-53 Oct-2023