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REVERSE AND ANATOMICAL SHOULDER REPLACEMENT

Method
Implantation of a reverse shoulder joint replacement
Duration
about 90-120 minutes
Recovery time
3 to 6 months

What is a reverse shoulder replacement?

The reverse shoulder replacement is a special form of artificial joint in which the natural anatomy of the shoulder is reversed. Unlike the anatomical replacement, here the ball is fixed to the shoulder blade and the socket to the head of the upper arm. This construction allows better function even where the rotator cuff is severely damaged.

The reverse shoulder replacement is used above all in patients with massive tears of the rotator cuff, with severe osteoarthritis and a deficient rotator cuff, or after a failed anatomical replacement. It offers good relief of pain and improved movement even when the rotator cuff no longer works.

Indications for a reverse shoulder replacement

  • Massive tears of the rotator cuff with pseudoparalysis
  • Severe osteoarthritis of the shoulder with a deficient rotator cuff
  • A failed anatomical shoulder replacement
  • Complex shoulder injuries with destruction of the joint
  • Rheumatoid arthritis with a severely deficient rotator cuff

How the operation proceeds

  • General or regional anaesthetic
  • Anterior or lateral approach to the shoulder
  • Removal of the damaged humeral head
  • Preparation of the socket and implantation of the ball
  • Fixation of the socket on the head of the upper arm
  • Reconstruction of the soft-tissue structures

Rehabilitation after a reverse shoulder replacement

Aftercare following a reverse shoulder replacement is decisive for long-term success. Early mobilisation and targeted physiotherapy are important in order to restore the movement and function of the shoulder.

Phase I (0-3 weeks): protection and rest
  • Sling for 2-3 weeks to take the load off
  • Cooling, pain management, lymphatic drainage
  • Passive mobilisation exercises under physiotherapy guidance
  • Avoiding load-bearing and active movement
Phase II (4-8 weeks): building up load
  • Weaning off the sling, progression to active movement
  • Active movement and muscle-building exercises
  • Functional training for everyday activities
Phase III (from week 9): functional training
  • Co-ordination, strengthening, making movement automatic
  • Sport-specific loading (from about 4 months)
  • Return to activity after clinical checks