Reverse Shoulder Arthroplasty/ Replacement

In reverse shoulder arthroplasty/ replacement, the ball of the joint is placed in the socket/ glenoid place while the socket is placed in the ball/ humeral head place. It is the opposite of the normal shoulder joint structure in which the ball is the humeral head, and the socket is the glenoid. So after reverse shoulder arthroplasty/ a replacement ball becomes the socket, and the socket becomes the ball.

Reverse Shoulder arthroplasty/ replacement is required in patients who have     

1. Rotator cuff tear, which can’t be repaired
2. Severe fracture of the proximal humerus
3. Previously failed replacement of Shoulder.

    a) Reverse shoulder replacement can be cemented in which cement is used to fix artificial components to bone. It means the ball/ humeral head and socket/ glenoid artificial components are fixed to the bone using cement.
    
    b) Reverse shoulder replacement can be uncemented in which the ball/ the humeral head is pressed to fit the bone, socket/ glenoid artificial components are pressed to the bone, and no cement is used.

It depends on:

1. Patients age
2. Quality of bone or density of bone
3. Surgeons’ preference

Ultimately the decision is taken in consultation with the surgeon.

If the patient has so much pain, even after taking treatment for a long duration, he is not able to perform his daily activities. Movement at the Shoulder is painful and does not allow you to comb your hair, take a bath, eat food properly, and do routine activities. Night pain is also present in the shoulder joint. So why wait and lose your quality lifetime? Consult your surgeon and make an informed decision.

        a. patients with physiological age >70
        b. low demand patients
         
Since the deltoid forms the fulcrum, it should be intact and properly working. The decision on the type of shoulder replacement has to be taken after proper investigation and consultation with the surgeon.

In cases of severe tear of the rotator cuff and severe fracture of the proximal humerus. The disease doesn’t get cured on its own. The problems/symptoms will increase, so why wait and lose your quality lifetime? “Don’t add numbers to your age. Add the quality of life to your age.”

It depends on the patient's haemoglobin before and after reverse shoulder arthroplasty/ replacement. Blood can be donated by patient relatives or arranged from the community blood bank.

Investigations are done before reverse shoulder arthroplasty/ replacement to check for fitness for reverse shoulder arthroplasty/ replacement. Investigations usually talk about the general medical fitness of an individual. The patient will require anesthesia, and if there is some problem, the underlying medical condition can be treated or controlled before surgery. It helps in reducing the chances of complications during and after surgery.

In general reverse shoulder arthroplasty/ replacement takes 2-3 hours.

If reverse shoulder arthroplasty/ replacement went normal without any complications and the patient was not suffering from another disease like diabetes, hypertension, asthma, etc., the patient is usually discharged after 2-3 days. But this duration may vary depending on surgeon preferences.

In patients after reverse shoulder arthroplasty/ replacement, heavy painkillers are used to make the patient comfortable. But in general, pain is reduced to a larger extent with painkillers, ice packs, and physical therapy. It usually takes weeks to months to be completely pain-free. But once the patient’s pain subsides, he becomes very happy.

Physiotherapy usually starts the next day of the operation, and the patient requires a few weeks to months of physiotherapy.

Physical therapy will be started the very next day of reverse shoulder arthroplasty/ replacement, your arm will be in a sling for 2-6 weeks, which depends on the severity of the disease pre-surgery and the surgeon’s preference, but during this time, you will be expected to do your physiotherapy as recommended. Most patients will be able to perform routine work within 4-6 weeks, avoiding heavy work. Complete recovery will take several months.

Usually, patients can take a shower after the first dressing of the wound. But the patient will have to wait 6 weeks to take a bath or use a bathtub.

Usually, the patient will be able to drive after 3- 4 weeks in consultation with your surgeon.

Risks may include stiffness of the Shoulder, infection, damage to nerves, implant loosening and failure, dislocation of the joint, fracture during surgery, in case of discharge from the wound, fever, severe pain, and excessive swelling; contact your surgeon immediately.

With the advancement of technology and better quality implants, reverse shoulder arthroplasty/ replacement has become a routine surgery worldwide. Most people will resume daily activities with proper follow-up care and physical therapy.

It depends on patient activity, age, and overall health. But the average knee lasts for 10-15 years.

It depends on the hospital category chosen by patients and the type of implant discussed. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery because we know treatment doesn’t end at the patient's discharge. To ensure the quick recovery of patients in simpainortho.com, we believe that a patient requires expert care within the most comfortable surroundings until he can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most of the insurances have included reverse shoulder arthroplasty/ replacement surgery.