A procedure where the ball and socket of the shoulder joint are reversed to improve function.
Through an open incision, the damaged joint surfaces are removed and replaced with prosthetic components in a reversed configuration, placing the ball where the socket normally sits and vice versa. This design allows the deltoid muscle to compensate for a rotator cuff that is no longer functioning. The procedure typically takes one to two hours, with patients usually staying in hospital for a few days.
Assessment includes examination and imaging, usually X-rays and an MRI, to confirm this specific type of replacement is appropriate given the state of the rotator cuff and joint. Preoperative preparation may include specific exercises alongside standard fasting and medication review, and arranging support at home during early recovery is recommended.
A sling supports the arm for the initial weeks, with physiotherapy introduced once the surgical team confirms it is safe. Pain is managed with appropriate analgesia in the early days. Recovery is gradual, with meaningful improvement in function continuing over several months.
Rehabilitation begins with gentle, guided movement, progressing to strengthening as healing allows, tailored to the specific implant used and the condition of the surrounding muscles. Regular follow-up helps guide the pace of activity as recovery progresses.
Risks include infection, which is a significant concern with any joint replacement, dislocation of the prosthetic joint, loosening of the components over time, and the general risks of anaesthesia. Some patients experience persistent stiffness or a more limited range of motion than a natural shoulder.
The goal is to relieve pain and restore functional shoulder movement, particularly in patients whose rotator cuff is too damaged for a standard shoulder replacement to work well. Many patients experience significant improvement in comfort and the ability to use the arm for daily activities, though overhead reach and heavy lifting are generally more limited than with a healthy shoulder.
Reverse shoulder replacement alters the normal ball-and-socket arrangement to allow the deltoid muscle to power arm movement, particularly useful when the rotator cuff is too damaged to function. Most patients experience significant improvement in pain and function.
