Advanced arthritis of the glenohumeral joint can be treated with shoulder replacement surgery, in which the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis.
Both the head of the humerus and the glenoid are replaced. A plastic “cup” is fitted into the glenoid, and a metal “ball” is attached to the top of the humerus.
In a reverse total shoulder replacement, the socket and metal ball are opposite a conventional total shoulder arthroplasty. The metal ball is fixed to the glenoid and the plastic cup is fixed to the upper end of the humerus. A reverse total shoulder replacement works better for people with cuff tear arthropathy because it relies on different muscles — not the rotator cuff — to move the arm.
Patients with severe pain, restricted range of motion, and poor function after primary shoulder arthroplasty, especially in cases with initially good results that deteriorated over time, should be considered for revision. The procedure should only be considered after a thorough history, physical examination, and appropriate laboratory studies and imaging have been carried out to delineate the possible causes of failure. Because the causes are often multifactorial, meticulous preoperative evaluation is paramount for success of revision arthroplasty.
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