When other therapies fail to restore shoulder function, reverse shoulder arthroplasty may be a viable option when performed by an orthopedic surgeon specializing in shoulder surgery, such as Khurram Pervaiz MD, a shoulder, elbow and hand specialist with Orthopaedic Associates of Central Maryland.
What Is a Reverse Shoulder Arthroplasty?
This procedure uses a single incision in the front of the shoulder. Through the incision, the surgeon replaces the entire ball and socket of the shoulder.
Conventional shoulder replacement surgery replaces the shoulder socket with a plastic socket and the “ball” at the top of the upper arm bone with a metal ball. In a reverse shoulder replacement, the ball and socket are switched.
“With the ball in the shoulder blade and the socket in the upper arm, you can function without a rotator cuff,” explains Dr. Pervaiz. The procedure allows the deltoid muscle—rather than the rotator cuff—to lift and move your arm. Dr. Pervaiz stresses that the procedure is typically used as a “last resort,” when other approaches do not provide relief.
This technique, FDA-approved in the United States in 2005, is complex and requires special training. It’s important to find a surgeon like Dr. Pervaiz, who has fellowship training in shoulder surgery and performs the surgery routinely to become proficient.
Am I a Candidate for Reverse Shoulder Arthroplasty?
The most common conditions that Dr. Pervaiz treats with this surgery are:
- Severe arthritis in the shoulder
- Major rotator cuff tears that cause weakness in the arm and arthritis
- Serious fractures in the ball of the shoulder joint, usually caused by an injury or trauma
Dr. Pervaiz notes that many of the patients he sees for this surgery are older adults in their 60s and 70s, or older.
Recovering from Surgery and Restoring Movement
After the surgery and an overnight hospital stay, patients wear a sling for about four weeks. Patients are allowed limited use of the arm immediately after the surgery and are allowed near unrestricted use within three months. Complete recovery takes an average of six months.
Dr. Pervaiz emphasizes the importance of physical therapy to help in the recovery process, and typically sends his patients to physical therapy right away. “Patients get better movement and regain strength faster with physical therapy than by exercising on their own,” he points out.
Performing about 100 shoulder replacement surgeries each year, Dr. Pervaiz notes that his patients do very well. “It really improves their quality of life—it reduces pain and improves their function,” says Dr. Pervaiz. “Some of my patients say it’s life changing.”