Reverse Shoulder Arthroplasty

Reverse Shoulder Arthroplasty
A newer type of shoulder replacement is called reverse total shoulder arthroplasty This surgery was developed in Europe in the 1980s, and it was approved by the Food and Drug Administration (FDA) for use in the United States in 2004. Reverse total shoulder replacement is often used for people who have shoulder arthritis coupled with an irrepairable rotator cuff tear (a condition called cuff tear arthropathy, or CTA). It is also performed for patients with very complex shoulder problems, including those with failed previous surgical treatments.


A reverse total shoulder prosthesis. Note that the ball and socket are "reversed"or switched .

Normally, the rotator cuff and deltoid muscles work together to allow a person to raise their arm overhead. With a large rotator cuff tear, the normal mechanics of the shoulder are disrupted, and it may be difficult or impossible for a patient to lift his or her arm. The reverse shoulder prosthesis provides a fixed fulcrum for the shoulder joint, allowing the arm to be raised overhead even when the rotator cuff muscles are absent.  

The results of reverse shoulder arthroplasty appear to be similar to that of total shoulder arthroplasty in some cases. In a recent paper, Boileau and associates reported that at about 40 months after the procedure 78% of patients were satisfied or very satisfied with the result, and 67% had no or slight pain. ( Boileau P, Watkinson D, Hatzidakis AM, and Hovorka I. Neer Award 2005: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg 15: 527-540, 2006).