Arthritis in your shoulder can make life miserable. The bone-on-bone pain can keep you up at night. You might have trouble with simple tasks, like buckling your seatbelt. That's why many people turn to joint replacement surgery. And now, most people have this procedure done in reverse. A UVA Health expert explains the pros and cons of a reverse shoulder replacement.
What’s a Reverse Shoulder Replacement?
Like other joints in the human body, you have bones that fit together in your shoulder like a ball in a socket. Imagine a baseball in a glove. The ball allows for movement. The socket keeps things in place.
With a regular shoulder replacement, doctors replace the ball with a new ball and the socket with a socket implant. The metal ball and plastic socket implants replace the worn bones.
A reverse shoulder replacement switches the placement of these pieces. “We put a ball on the socket side and a socket on the ball side,” says Brian Werner, MD. He’s a UVA Health sports medicine orthopedic surgeon. He specializes in all types of shoulder joint replacement surgery.
Why Surgeons Go in Reverse
Reverse shoulder replacements now make up more than 60% of all shoulder joint replacements. The #1 reason? Many people with arthritis don't have a working rotator cuff. That's the part of the shoulder made up of four tendons that stabilize the joint.
Werner explains: “If you do a regular shoulder replacement in that patient, they can't lift their arm up and actually use their arm. We found that a reverse replacement works very well in those patients.”
But you could also benefit from this option if you have:
- A shoulder fracture
- Shoulder arthritis with a very worn-out socket
Reverse Shoulder Replacement Pros
After surgery, you can expect to:
- Live without or reduced shoulder pain
- Regain your range of motion
- Get back to the sports and activities you love
Reverse Shoulder Replacement Cons
This kind of procedure does carry risks. You do face the risk, after surgery, of:
- Losing the ability to reach behind your back to scratch or change a bra
- Getting an infection
- Suffering from some joint instability
- Bone fracturing around the implants
Doctors can treat any infection that develops. And they can fix other issues with a revision surgery, Werner notes. The newest reverse shoulder implants have only been around 5-10 years. So it's hard to know how long they’ll last.
Surgery is Not 1st Option for Pain
Shoulder arthritis causes the same symptoms as other injuries:
- Pain in the shoulder, particularly at night
- Limited shoulder movement, like reaching, carrying, or lifting
- Stiff shoulder
After diagnosis with an X-ray image and physical exam, doctors look at next steps. Werner says, “With shoulder arthritis, we don’t jump straight to a replacement.”
Instead, Werner and team will try to reduce pain with:
- Physical therapy
- Over-the-counter anti-inflammatory pain medicine
Think You Need Shoulder Replacement Surgery?
Talk with an expert about the pros and cons.
- Steroid injections
Why Go Where Many Get Done
Reverse shoulder replacement is a challenging surgery. “It takes a significant amount of expertise to get it right,” Werner explains.
Werner, along with Stephen Brockmeier, MD, have fellowship training in shoulder replacement. That means they've focused extra time on performing this procedure. Combined, they do more than 300 shoulder joint replacements each year. That puts UVA Health among an elite group in the U.S.
Werner says, “We have a lot of experience doing shoulder replacements. That helps produce good outcomes. Our patients are more likely to benefit from the pros, and not experience the cons, of reverse shoulder joint replacement.”