Reverse Shoulder Replacement

What Is a Reverse Shoulder Arthroplasty?

A reverse shoulder arthroplasty (aka replacement) is a surgical procedure in which parts of an arthritic joint are replaced with a prosthesis or artificial joint. The normal shoulder is a ball-and-socket joint. The ball is called the humeral head, and the socket is called the glenoid. The reverse shoulder arthroplasty changes the orientation of the shoulder so that the arthritic socket (glenoid) is replaced with an artificial ball, and the arthritic ball (humeral head) is replaced with an artificial socket (humeral implant) into which the ball rests. Reverse shoulder arthroplasty is used for arthritic shoulders that lack an intact rotator cuff. It may also be used for fractures or severe bone wear due to arthritis.

How Is the Shoulder Replaced?

The prosthesis will be placed through an incision along the front of the shoulder. The ball component is anchored in place with screws while the socket is secured inside the humerus, and bone grows into it over time. Occasionally, cement is required to secure the socket inside the humerus.

Anesthesia

The surgery is performed under general anesthesia. You will also receive a nerve block on the day of surgery to help control your postoperative pain. Your arm will be numb from the nerve block for about 12 – 14 hours. The anesthesiologist will speak to you more about this on the day of surgery.

Incision

You will have an incision along the front of your shoulder, approximately 5 inches long.

Sling

Your arm will be placed in a sling after surgery. You will remain in the sling 24/7 until you see the physician for your first postoperative appointment. This includes sleeping! The sling can only be removed for dressing and showering.

Dressings

You will go home with a clear dressing over the incision. Underneath, you will see skin glue which is used to seal the sterile incision from the outside world. Leave the dressing in place until your first postoperative visit. You may shower with this dressing.

Blood Thinners

In most cases, aspirin will be prescribed for 4 weeks. This is to prevent blood formation. If you are considered high risk or have a history of blood clots, other medications may be prescribed. DO NOT take these medications AND aspirin simultaneously.

Restrictions

Recovery from a reverse shoulder replacement is 3 months. During that time, you will have limitations on the use of your arm. You may drive when you feel that you can safely control a vehicle, and you are NOT taking narcotic pain medication.

Timeline

Surgery to Week 6: No active reaching and lifting. No reaching behind your back or overhead. No pushing up from a chair or closing doors.

Dental Procedures

All dental procedures should be avoided for 3 months after surgery. If you require dental work sooner, please contact our office for an antibiotic prescription. After 3 months, antibiotics are not required for dental procedures.

We thank you for entrusting your shoulder care to Carrell Clinic. If you have any concerns, questions, or issues, please call us at (214) 397-1505.

Dr. Holt Cutler