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April 20, 2021  
SHOULDER NEWS: Feature Story

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  • Reversing Shoulder Problems

    Reversing Shoulder Problems

    October 27, 2005

    By: Shelagh McNally for Shoulder1

    Imagine not being able to lift your arm to brush your hair or put the dishes in the cupboards. Shoulder problems can be one of the most debilitating injuries leaving a person in constant pain with lack of mobility. Whether the problem stems from an injury or from arthritis, there is often little to be done to fix it – particularly if the injury was in the rotator cuff. But, a new technique known as a reverse total shoulder replacement is giving people with chronic shoulder pain a new beginning.
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    Before Surgery

    You may need to take antibiotics before and after dental surgery to prevent an infection from your mouth moving to your shoulder replacement.

    While movement will be restored, your shoulder will not move as far as it did before your injury but you will be able to participate in more of your activities without pain.

    You will still have to avoid activities that put a lot of stress on your shoulder joint.

    After surgery

    Contact your surgeon if you notice any redness or drainage from the wound.

    Take your temperature twice a day and notify your doctor if you have a fever over 100.5°F.

    Use an ice pack to relieve soreness.

    Follow your rehabilitation schedule faithfully. This usually includes six weeks of limited activity with supervised exercise and stretching.

    The shoulder is both wonderful and terrible. Wonderful because it has so much flexibility and allows so much movement. Terrible because is it one of the most unstable joints in the human body. Three bones come together in one place and two joints facilitate the movement. The humerus (arm), scapula (shoulder blade) and clavicle (collarbone) meet at the top of the shoulder. The GH joint (glenohumeral) is the ball and socket that rests between the humerus scapula. The rotator cuff is made up of four muscles that keep the ball and socket in place, allowing it to rotate and lift the shoulder. This set-up allows for lots of movement but also for many problems. Frequently the rotator cuff is injured by tears, tendonitis, impingement, bursitis and strains but also by arthritis.

    A common problem is rotator cuff arthropathy, an arthritic condition causing the rotator cuff to tear and the surface of the upper arm bone to collapse. Over time the pain gets progressively worse and mobility is severely limited. While the standard shoulder replacement surgery where the ball and socket is replaced can often repair a small rotator cuff, it can’t help with more severe injuries where there is significant loss of mobility. The reverse total shoulder replacement successfully treats the problem by switching the placement of the metal ball and socket. The metal ball is attached to the shoulder blade and the socket onto humerus opposite to a normal shoulder. Better use is made of the large triangular deltoid muscles covering the shoulder joint. Reversing the ball and socket shifts the center of rotation making the intact (and much stronger) deltoid muscle move the arm rather than the damaged rotator cuff. The general shape of the shoulder remains the same and mobility is restored.

    “This is an implant that allows us to salvage many of those otherwise previously untreatable conditions”, said Dr. Peter Millett, Associate Surgeon at the Steadman Hawkins Clinic in Vail, Colo., who specializes in shoulder, knee and sports medicine. “I recently did surgery on a delightful women who hadn’t been able to comb her hair since the 1980s because of massive rotator cuff tears in both her shoulders. Otherwise, she was vibrant and healthy. She said she hadn’t been able to take care of herself for two decades! She is now pain free and can raise her arms over her head. The surgery changed her life.”

    Last updated: 27-Oct-05


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