The shoulder is a ball-and-socket joint with the round ball found on top of the arm bone (humerus) and the socket on the shoulder blade (glenoid). A reverse total shoulder replacement is a design in which the location of the ball and the socket are swapped. The metal ball is attached to the glenoid (socket) while the plastic socket is attached to the top of the humerus (upper arm bone). This design allows the deltoid muscle to lift the arm instead of the torn rotator cuff. In a healthy shoulder, the rotator cuff (a group of 4 muscles) envelops the shoulder joint providing stability and movement. When the rotator cuff is substantially torn, the shoulder joint will become unstable and may lose much of its ability to move. When a total shoulder replacement surgery is performed, the orthopedic shoulder surgeon determines which type of replacement design to use based on the status of the rotator cuff and the quality and quantity of bone available at the glenoid (socket). An anatomic total shoulder replacement is used when the rotator cuff is in good condition. The metal and plastic components resemble the native shoulder joint. If the rotator cuff is not in good condition or if there has been a failed prior shoulder surgery, a reverse total shoulder replacement is used. The reverse total shoulder will give the best results in these cases, typically allowing the patient to now raise the arm higher and without pain. Shoulder replacement surgery is a procedure that takes specialized surgical training and experience to optimize patients' results. In the right hands, shoulder replacement surgery is very effective in relieving pain and restoring function to those suffering from shoulder arthritis. Michael A. Cohn, M.D. Orthopedic Surgeon Shoulder to Hand Surgery Orthopedic Center of Palm Beach County (561) 967-6500 Reverse Total Shoulder Replacement
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