Reverse shoulder replacement is a surgical procedure used to address complex shoulder conditions, particularly when the rotator cuff muscles are severely compromised or damaged. In this procedure, the arthritic joint surfaces are removed, contracted soft tissues are released, and a specialized prosthetic design featuring a metal socket and a specially engineered plastic ball is implanted. Unlike traditional shoulder replacement, the "reverse" configuration of this prosthesis switches the positions of the ball and socket, which allows the deltoid muscle, instead of the damaged rotator cuff, to control and stabilize the shoulder joint. Reverse shoulder replacement is typically recommended for individuals with severe rotator cuff dysfunction or certain shoulder pathologies, with the primary goal of relieving pain, restoring function, and improving shoulder stability.
The reverse shoulder replacement surgery procedure involves a series of carefully orchestrated steps to address complex shoulder conditions, particularly when the rotator cuff muscles are significantly compromised. It commences with the creation of an incision on the front of the shoulder, granting access to the shoulder joint. The surrounding muscles and tissues are gently separated to expose the joint, with only one rotator cuff tendon, typically the subscapularis, being detached in most cases to facilitate access.
Following this, meticulous bone preparation is carried out to address the arthritic or damaged segments of the shoulder joint, which may necessitate the removal of compromised bone and cartilage. The critical aspect of the surgery is the implantation of specialized prosthetic components, featuring a metal socket and a plastic ball, configured in a unique "reverse" design. This design change places the ball and socket in reversed positions, enabling the deltoid muscle to control and stabilize the joint, compensating for the damaged rotator cuff. The surgery concludes with the reattachment of the previously detached rotator cuff tendon using sutures, and the incision is meticulously closed with sutures or staples, ensuring the surgical site is securely dressed. Reverse shoulder replacement surgery is primarily intended to restore functionality, alleviate pain, and enhance stability, particularly in cases of severe rotator cuff dysfunction or specific shoulder pathologies. The precise execution of these steps may vary based on the patient's individual condition and the chosen surgical approach.
