Reverse total shoulder replacement is recommended for people who do not have a functioning rotator cuff. For these individuals, an anatomical total shoulder replacement can still leave them with pain and the inability to lift one’s arm past 90 degrees.
The design of this surgery is very innovative. As the name implies, the shoulder prosthesis does not recreate normal anatomy, instead the socket and metal ball are switched. That means a metal ball is attached to the shoulder bone and a plastic socket is attached to the upper arm bone. Patients receiving a reverse total shoulder replacement have a functioning deltoid muscle, which is the large muscle on the side of the shoulder, and a non-functioning rotator cuff, usually due to a large irreparable rotator cuff tendon tear. This procedure greatly improves the function of the shoulder by absorbing the some of the role of the absent rotator cuff. The prosthesis provides a stable and constant center of rotation, allowing the deltoid muscle to elevate the arm.
While this procedure does not make your shoulder normal, it does improve the function and reduces or eliminates shoulder pain. The prosthesis is non-atomic, but patients can expect to use the shoulder for light activities such as hunting, fishing, playing golf, riding horses, and doing lightweight training exercises in the gym. Most patients are able to drive within three weeks of surgery.