In reverse total shoulder replacement, the socket and metal ball are switched. That means a metal ball is attached to the shoulder bone and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.
Completely torn rotator cuffs with severe arm weakness
The effects of severe arthritis and rotator cuff tearing (cuff tear arthropathy)
Had a previous shoulder replacement that failed
For these individuals, a conventional total shoulder replacement can still leave them with pain. They may also be unable to lift their arm up past a 90-degree angle. Not being able to lift one’s arm away from the side can be severely debilitating.
A shoulder surgery has failed when it does not achieve the expectations of the patient and the surgeon. Failure can result from stiffness, weakness, instability, pain or failure to heal as well as from complications such as infection or nerve injury. Every surgery has a risk of failure whether it is an operation for dislocation, rotator cuff tear, arthritis or fracture. Because fracture fixation, Bankart repairs, rotator cuff repairs, shoulder joint replacements and reverse total shoulders are performed commonly, a substantial number of patients have experienced these failures.
While pain is often a presenting complaint, our physicians will try to determine if the shoulder is stiff, unstable, weak or crepitant, in that each of these mechanical characteristics provides clues to what may be going on with the joint. For example a shoulder arthroplasty may be stiff because of adhesions (scar), blocking osteophytes (bone spurs), or over-stuffing (too large prosthetic components). Weakness may result from rotator cuff failure, subscapularis detachment, nerve injury, deltoid detachment, or disuse atrophy of the muscles. Instability may result from suboptimal positioning of the components, component loosening or soft tissue imbalance. Crepitation, clicking, or clunking may result from component loosening, soft tissue in-growth, loose bodies within the joint or joint surface irregularities.