Reverse Shoulder Replacement Surgery

People with rotator cuff tears may not be a good fit for conventional shoulder replacement surgery. Instead, an alternative called reverse shoulder replacement surgery may offer the best results.

Conventional total shoulder replacement provides a good option for patients with bone-on-bone osteoarthritis and intact rotator cuff tendons. Reverse shoulder arthroplasty is best for certain patients with irreparable rotator cuff tears and a form of shoulder arthritis resulting from rotator cuff dysfunction, known as cuff-tear arthropathy.

The experts at UT Southwestern Medical Center's Sports Medicine, Shoulder, and Knee Service can help you determine which shoulder replacement surgery would benefit you most. 

Benefits of Reverse Shoulder Replacement Surgery

In a reverse shoulder replacement, your surgeon puts a socket on the ball side of the joint and a ball on the socket side of the joint (the opposite of what happens in a conventional shoulder replacement surgery).

This allows patients to elevate their arm with the use of the deltoid muscle despite a deficiency in the rotator cuff. 

Several studies show that reverse shoulder replacement surgery results in improved range of motion and relief from pain, even for those with limited use of the arm before the operation.

Additional long-term benefits include:

  • 83 percent of patients report relief from moderate to severe pain after 12 years.
  • 93 percent of patients don't require revisions after 10 years; 87 percent don’t need revisions even 15 years after surgery.

Complications from Reverse Shoulder Replacement

Reverse shoulder arthroplasty is an increasingly promising option, due to ongoing improvements in techniques and designs since initial approval of the procedure by the Food and Drug Administration in 2004. But it's not for everyone. 

Complications can include:

  • Dislocation
  • Stress fractures
  • Brachial plexopathy – decreased sensation in the arm
  • Scapular notching – erosion of the shoulder blade

Before choosing a reverse shoulder replacement, consider other treatments such as arthroscopic debridement, biceps tendon release, and other rotator cuff defiant implants. Whatever treatment you choose, it should be tailored to your individual needs.

Experts in Shoulder Replacement Surgeries

For the greatest chance of success, it's essential that you select a surgical team with experience in these types of surgery.

Dedicated specialists at UT Southwestern – like Bill Robertson, M.D., and Michael Khazzam, M.D. – perform dozens of such surgeries annually. At other centers, up to 75 percent of shoulder replacement surgeries are done by surgeons who perform only one or two procedures annually.

UT Southwestern’s Sports Medicine, Shoulder, and Knee Service treats the whole range of shoulder disorders, including acromioclavicular joint injuries, arthritis, bursitis, capsular and labral injuries, dislocations or instability, fractures of the shoulder or clavicle, frozen shoulder, rotator cuff tears and injuries, SLAP tears, and tendonitis.

Call UT Southwestern Patient and Physician Referral Services at 214-645-8300 for more information about our Sports Medicine, Shoulder, and Knee Service, or to schedule an appointment with Dr. Robertson.