Reverse shoulder arthroplasty was specifically designed for those with torn or malfunctioning rotator cuffs. During the procedure, damaged parts of the rotator cuff are replaced with prostheses or artificial components to improve the functionality of the joint and enable you to use different muscles for lifting and rotating the arm.
Rotator cuff injuries are common for active individuals and often increase with age. Rotator cuff injuries can cause shoulder dislocations, dull aches, pains, stiffness, and discomfort. Rotator cuff injuries can also occur due to overuse, injury, falls, accidents, repetitive activity, or conditions that weaken the joint, such as arthritis.
Reverse shoulder arthroplasty is typically recommended for those with rotator cuff tears and injuries that do not improve after other treatment methods such as painkillers and physiotherapy.
How does reverse shoulder arthroplasty work?
In total shoulder arthroplasty procedures, a shoulder replacement device similar to the natural anatomy of your shoulder is used to replace the damaged joint. A cup made of plastic is inserted into the shoulder socket while a metal ball is attached to the humerus (upper arm bone).
In reverse shoulder arthroplasty, the placement of the socket and metal ball are switched – the metal ball is attached to the socket while the plastic cup is attached to the humerus.
During a standard shoulder replacement surgery, the muscles and tendons should be intact to support the new joint. If not, the patient may still experience pain and a limited range of motion after the shoulder replacement. So when there is too much damage in the tendons surrounding the rotator cuff, a reverse shoulder arthroplasty is recommended. After surgery, you will be able to utilise the deltoid muscle to move and lift your arm instead of depending on the rotator cuff and its surrounding muscles and ligaments.
Benefits of reverse shoulder arthroplasty
Eliminates pain due to rotator cuff injuries
Improves range of motion and flexibility
Strengthens and stabilises the shoulder joint
Improves quality of life
What conditions can reverse shoulder arthroplasty treat?
A reverse shoulder arthroplasty can treat the following conditions:
Shoulder injuries: such as rotator cuff tear, fractures.
Medical conditions: such as arthritis, proximal humerus tumours.
What results can I expect?
After a reverse shoulder arthroplasty, you can expect to feel pain and swelling in the arm and shoulder for a few days. This is normal and should clear up in a couple of weeks.
However, it can take up to 4-6 months for a full recovery. During this time, physiotherapy sessions are recommended to strengthen the shoulder and improve flexibility.
Exact results differ from person to person as it greatly depends on medical history, the complexity of the shoulder injury, and age. However, it is known as a successful procedure to treat rotator cuff injuries and many patients experience reduced pain and stiffness, and improved range of motion and stability in the shoulder joint after a full recovery.
Work closely with your orthopaedist and follow their recommendations for exercises and activities for the best results.
How many treatment sessions are needed?
Only 1 procedure at a time is required for reverse shoulder arthroplasty.
However, you will be required to attend physiotherapy sessions and follow-up appointments with your orthopaedist to ensure proper healing and functioning of the replacement joint.
Your orthopaedic surgeon will be able to provide you with a bespoke treatment plan, tailored to your needs and requirements.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.