Reverse Shoulder Arthroplasty

What Is Reverse Shoulder Arthroplasty?

Reverse shoulder arthroplasty, also called reverse shoulder replacement, is a surgical procedure where the normal ball-and-socket structure of the shoulder joint is reversed. In this surgery:

A metal ball is placed on the shoulder blade (scapula).
A plastic socket is attached to the upper arm bone (humerus).

This design allows the shoulder to function even when the rotator cuff muscles are severely damaged, by relying more on the deltoid muscle to lift and move the arm.

Why Is It Needed?

Your doctor may recommend reverse shoulder arthroplasty if you have:

Severe rotator cuff tears that cannot be repaired.
Cuff tear arthropathy (arthritis combined with rotator cuff damage).
Complex shoulder fractures that cannot be fixed with plates or screws.
Failed previous shoulder replacement.
Persistent pain and loss of function despite non-surgical treatments.

The Procedure Step-by-Step

Evaluation – X-rays, scans, and physical exams confirm the extent of damage.
Anesthesia –General or regional anesthesia is given.
Incision – The surgeon makes an incision to access the shoulder joint.
Removal – Damaged bone and cartilage are removed.
Implant placement – The ball and socket are reversed: ball on the shoulder blade, socket on the arm bone.
Closure – The incision is closed, and recovery begins.

Recovery and Rehabilitation

Hospital stay:Usually 2–3 days.
Arm movement:Gentle exercises begin soon after surgery.
Physiotherapy: Essential to restore strength and mobility.
Return to activities: Most patients resume daily activities in 6–12 weeks.
Longevity: Modern implants often last 10–15 years or more.

Benefits

Restores shoulder function when rotator cuff is irreparably damaged.
Provides significant pain relief.
Improves mobility and independence.
Allows patients to return to daily activities.

Risks & Considerations

Infection, blood clots, or implant loosening (rare).
Nerve injury or stiffness.
Revision surgery may be needed if the implant wears out over time.
Not suitable for patients with good rotator cuff function (they may benefit more from total shoulder arthroplasty).

Key Message for Patients

Reverse shoulder arthroplasty is a safe and effective option for patients with severe rotator cuff damage or complex shoulder problems. By reversing the ball-and-socket design, the surgery allows the deltoid muscle to take over shoulder movement, restoring function and reducing pain. With proper rehabilitation, most patients regain independence and enjoy long-lasting results.

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