By Dr. Timothy Lehman, orthopedic surgeon
Patients who have lost the use of their shoulders due to irreparable rotator cuff tears may be candidates for reverse total shoulder replacement.
This surgery was approved for use in the United States in 2004 and is just beginning to become more widely available for shoulder conditions that were previously untreatable, including:
- Completely torn rotator cuffs
- Severe arthritis due to rotator cuff tears (cuff tear arthropathy)
- Failed previous shoulder replacement
In this surgery, the artificial shoulder is implanted backwards with the “ball” attached to the shoulder blade and the socket or “cup” attached to the upper arm bone. This is why the procedure is known as a reverse shoulder replacement.
By implanting the artificial joint backwards, it provides an artificial fulcrum against which the deltoid muscle can elevate the arm rather than depending on the rotator cuff muscles to initiate the movement.
The most likely candidates for this surgery have lost the use of their rotator cuff due to a traumatic injury or tear that was untreated or failed surgical repair. Over time, this tear can cause severe arthritis. This surgery is generally not used for younger patients as other alternatives may be better options.
This is a highly technical surgery that, like all surgeries, has a risk of complications such as shoulder dislocation and infection.
Patients can find more information on this procedure at the American Academy of Orthopaedic Surgeons website.
Timothy Lehman, MD, is a board-certified orthopedic surgeon with the Center for Orthopedics in Littleton, Colorado. Dr. Lehman is also a fellow of the American Academy of Orthopaedic Surgeons and specializes in arthroscopic (minimally invasive) surgery of the shoulder, knee and elbow.