Featuring Dr. Patrick Chin, MD, MBA, FRCSC, Orthopedic Surgeon

What is Reverse Shoulder Replacement Surgery - Orthopedic Surgery Duration: 2 minutes, 33 seconds    

Reverse shoulder replacement surgery is fairly new in the last 10 to 20 years.  

It’s become more popular again. It has to do with a specific type of arthritis. So these rotator cuff tendons rotate the shoulder around and keeps the ball and socket centered.  

When these tendons are no longer present or deemed irreparable, then the ball no longer is depressed down against the socket and as a result it will slide upward like that.

And when you slide upward like that then the head and socket no longer is aligned, it changes the joint reaction forces, resulting in a different type of arthritis known as the cuff tear arthropathy.  

The conventional shoulder replacement requires the availability and the presence of these tendons for it to work. Otherwise the prosthesis will dislocate or sublux or partially dislocate upward.  

As a result the reverse prosthesis basically reverses the ball and socket joint so that we can then go without these tendons and now use a different muscle configuration and it has to be a biomechanical change in the center rotation to allow the patient now to elevate their arm using the big muscle called the deltoid muscle which you don’t see in this model.  

So using the deltoid muscle the patient will then be able to elevate their arm without the rotator cuff tendons being intact. It allows the patient now to to elevate the arm without dislocating the shoulder and without pain.

The prognosis of patients from a reverse prosthesis is good in terms of pain relief and improvement in function, especially in the ability to elevate their arm.  

In terms of the survivability of these implants, it is still difficult to predict, or a bit unknown only because over the last 10 years the reverse prosthesis designs have evolved quite rapidly.  

As a result we still hope that these implants will provide better longevity for our patients in terms of improving their pain and more long lasting functionality of the shoulder.  

Presenter: Dr. Patrick Chin, Orthopaedic Surgeon, Vancouver, BC

Local Practitioners: Orthopaedic Surgeon