Painful shoulder conditions, such as shoulder arthritis and rotator cuff tears, are common. Treatments such as medications, physical therapy, and steroid injections can help, but sometimes surgical options are the best way to provide long lasting pain relief.

Reverse shoulder replacement is an option for people with severe shoulder pain who have shoulder arthritis and rotator cuff damage. This procedure is a joint replacement that also reverses the position of the socket and ball of your shoulder joint.

Reverse shoulder replacement is a newer pain-relieving option in the United States, but it is growing in popularity.

A reverse total shoulder replacement is a specialized procedure that can be done for people who have severe pain from rotator cuff injuries and shoulder arthritis.

The procedure works by replacing the ball and socket joint of your shoulder. In the natural joint of your shoulder, the ball part of the joint is on your arm, and it fits into your shoulder.

As its name suggests, this surgery reverses how your shoulder joint works. Unlike in your natural shoulder joint, in this surgery, the ball is attached to your shoulder bone, and the socket is attached to your upper arm bone. You will use shoulder muscles instead of your rotator cuff to stabilize your new joint.

Medical illustration of how reverse shoulder replacement surgery changes your shoulder joint. Share on Pinterest
Medical Illustration by Bailey Mariner

A reverse shoulder replacement is a complicated surgical procedure. It can help people who have shoulder pain and difficulty with shoulder movement. Yet experts do not recommend it for everyone, according to a 2020 research review.

There are pros and cons to the procedure.

Pros of reverse shoulder replacement

  • The surgery can reduce pain.
  • The surgery can improve your range of motion.
  • The surgery can improve your quality of life.

Cons of reverse shoulder replacement

  • Surgery carries the risk of infection.
  • Surgery can result in joint instability.
  • The replacement joint might wear out.
  • The bone around the replacement joint could be damaged during the procedure.

Reverse shoulder replacement can be done either in-patient or outpatient, depending on your surgeon and your individual needs. You can discuss this with your surgeon ahead of the procedure.

You can also discuss ways to prepare at home. Your surgeon can advise you about steps such as:

  • when to stop taking certain medications, especially medications that affect your blood
  • when to shower or bathe before surgery
  • how much to eat or drink the morning of your surgery

Additionally, you can decide the type of anesthesia and sedation you’ll receive during your procedure. Most often, a reverse shoulder replacement is done under general anesthesia, but some facilities do offer additional options.

No matter what, it’s important to arrange a way to get home. You won’t be able to drive after sedation and surgery; taking public transportation could also pose a risk to your new shoulder joint. It’s recommended that you arrange for someone to drive you and help you get safely.

The cost of reverse shoulder replacement surgery depends on your location, surgical center, and the complexity of your surgery. You might have insurance coverage for your reverse shoulder replacement surgery.

Since reverse shoulder replacement surgery is used to treat arthritis and severe rotator cuff tears, it can be considered medically necessary. Under most insurance plans, including Medicare, this means it qualifies for coverage.

That said, it’s important to check your plan. You might need to meet certain requirements before coverage is offered. If your shoulder doesn’t meet your insurance company’s criteria, you might be denied surgical coverage.

Your doctor will go over your specific movement limitations after reverse shoulder replacement. Immediately following surgery, your arm will be in a sling or brace. You’ll likely be advised not to move your shoulder for at least a few days.

You’ll have physical therapy sessions scheduled to help strengthen your shoulder and improve your range of motion. The complexity of your surgical procedure will influence your recovery timeline, but most people are able to eat, read, use a keyboard, and dress themselves in about a week.

Your doctor and physical therapist will let you know when it is safe to return to all standard movements.

Recovery from reverse shoulder replacement surgery generally takes 4 to 8 months. Your surgeon and physical therapist will help you during rehab and recovery.

You’ll gradually gain strength in your shoulder, and your range of motion will increase. As you recover, you’ll be allowed to take on more activities. For instance, your doctor will tell you when it is safe to drive, return to work, or take on other daily activities.

At-home exercises for reverse shoulder replacement

You’ll receive at-home exercises from your physical therapist. They will tailor these exercises to your recovery. Common exercises for reverse shoulder replacement include:

  • Gently stretch your head from side to side.
  • Stand with your back to a wall. You should be about 2 feet from the wall. Swing your arm backward gently to touch the wall.
  • Stand with your palms on the wall in front of you. You should be about 3 feet from the wall. Walk your hand slowly up the wall with your fingers.
  • Hang a pulley or rope over a door and hold on to both ends. Use your good arm to pull your recovering arm up gently.
  • Sit with your elbow bent and resting on a table. Rotate your shoulder outward.

How long does it take to recover from reverse shoulder replacement?

Your total recovery time will depend on the complexity of your procedure and on how well your shoulder heals. Recovery typically takes between 4 and 8 months.

Certain factors, such as your lifestyle, can also make a difference. For instance, it generally takes less time to get cleared to return to an office job than a highly physical job.

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Reverse shoulder replacement surgery is highly successful as a pain-relieving procedure. In a study from 2020 including 21 people, for example, 88% reported decreased pain and increased functioning after the surgery.

Most people who have reverse shoulder replacement surgery do see an improved range of motion. Yet the success rate for the range of motion is not as high or predictable as it is for pain relief.

Reverse shoulder replacement is a newer surgical option in the United States. It was approved by the Food and Drug Administration (FDA) in 2003.

This means we don’t have data yet on how long lasting these reverse joints will be. This technique has been used in France since the 1980s, though, and European data shows that reverse shoulder replacements typically last about 15 years.

A reverse shoulder replacement is a joint replacement option for people with a damaged shoulder joint and severe shoulder pain.

The procedure replaces the damaged shoulder joint by putting the replacement joint pieces in reverse places. The ball joint is attached to the shoulder bone, and the socket is attached to the upper arm bone.

This surgery is very effective at providing pain relief. Recovery can take between 4 and 8 months and is aided by physical therapy sessions.