It's vital to understand how your shoulder anatomy would change after a reverse shoulder replacement before considering the Pros and Cons of reverse shoulder replacement. According to the Agency for Healthcare Research and Quality, over 53 thousand people in America have shoulder replacement surgery each year. If you or your beloved ones are one of them, it's the right to know a little in detail to be on the safer side.
A reverse shoulder replacement or Reverse Shoulder Arthroplasty is a surgical procedure that replaces the head of the humerus with a prosthetic ball and socket. This procedure aims to restore the patient's range of motion, improve their function, and reduce pain.
The risks and benefits of this surgery should be discussed carefully with your doctor before deciding whether or not to proceed with it. The recovery time for this surgery is significantly less than the recovery time for traditional shoulder replacement. Although post-operative pain may be worse, there are fewer complications and, therefore, a lower risk for infection.
According to collective research, an estimated 823,361 patients in the US were living with a shoulder replacement, while most of them were adult males and females. Nearly 60% of the patients had undergone reverse shoulder replacement surgery between 2013 and 2017.
The pros of reverse shoulder replacement are that it helps correct bone, cartilage, and muscle defects. It also works to improve the quality of life for individuals who experience pain due to arthritis-related conditions or who are experiencing wear and tear on the joint. Some other benefits of Arthroplasty are mentioned below.
After the surgery, there is less postoperative pain because this procedure doesn't involve cutting muscles. There will be significant arm and rotator cuff strength deficits that will require rehabilitation to correct.
According to a study from Europe, 85-90% of patients report that their quality of life has significantly improved after a reverse shoulder replacement due to performing activities without experiencing pain.
Patients are typically in the hospital 1-2 days after a reverse shoulder replacement compared with 5-6 days for traditional shoulder replacements, so you can go home sooner if you have someone to assist you. You should plan on being out of work for 2 months if you are an average worker so your employer can estimate how long you will be out of work to facilitate planning.
There is a lower risk for infections (0.7% to 4%) after this procedure than traditional shoulder replacement due to no muscles being cut during surgery. In observing 5-year, 10-year, and 20-year, infection-free rates of 99.3%, 98.5%, and 97.2% were noticed among patients after the surgery, respectively.
This study indicates the surgery has a high success rate even if you undergo surgery at 80 years of age or more. Even so, it's important to consult your doctor regarding possible infections.
Some patients who have reverse shoulder replacement report that the prosthetic socket is smaller than their original ball and socket, making it easier for them to return to physical activity post-surgery. Doctors do prescribe you a light home exercises programs regularly.
However, make sure not to take any arm positions like behind your body or straight outside while the first 6 weeks after surgery as this may cause problems with blood circulation in the newly restored joint area.
If you have trouble removing your prosthesis, there are fewer risks involved with this procedure, so you may find it more feasible to get it removed by a local doctor rather than having to travel or be admitted into the hospital.
Also note, that if an infection spreads in the bone, it's easier for a surgeon to access due to easily seeing when they're working instead of looking through muscles like they would when doing traditional shoulder replacement surgery.
The cons of reverse shoulder replacement are that in some cases, it can be very painful and take a long time to heal. It also doesn't provide the same stability as the original shoulder joint and could result in early osteoarthritis. Some other complications after reverse shoulder replacement are listed below.
Even though the prosthetic socket is smaller, it's still a foreign object replacing the natural head of the humerus. This means you will not be able to move your shoulder in certain directions like you used to be able to because the socket only allows movement in certain planes (planes are defined by lines that run through structures).
The decreased range of motion may mean that these muscles will get injured again without proper strengthening exercises because they won't have enough strength or endurance when they're needed. Before surgery, you should discuss this with your doctor so you know how much weight and what types of activities you should avoid after surgery until your rotator cuffs can tolerate it.
It's harder for a surgeon to remove or replace the prosthesis in this procedure, so you may not be able to have it repaired if there are complications with it. It should also be noted that it can be difficult to fit the socket over the new shoulder joint, which means you would need to get an entirely new implant instead of just switching out parts.
Joint immobilization and limited range of motion are common cons of reverse shoulder replacement procedure initially. You will have a limited range of motion following your reverse shoulder replacement surgery, but this is critical to avoid unnecessary stress on the affected joint.
It's best for friends and family members who haven't seen you in action before now- post operation so that they can help move items from higher shelves down close enough where it'll be easier access without having strain when using those fingers.
It typically takes patients 8-12 months to recover from reverse shoulder replacement instead of 3-6 months for traditional shoulder replacement, which means more time away from work and less money in the bank if you're unable to go back.
This is one of the main reasons why many surgeons recommend this procedure for those at high risk for infection or over the age of 60 years old because they wouldn't be able to make up for lost wages due to increased recovery times as younger, healthier people could.
Is Reverse Shoulder Replacement Surgery for You?
No one type of shoulder replacement is better than another - it's all based on what your personal preferences are. If you're at a higher risk for infection, this procedure may be better for you because it's easier to take out if there is an issue with the implant.
On the other hand, if you want to get back to normal activities as soon as possible after surgery, a traditional shoulder replacement may be more ideal for you.
One thing to note is that reverse shoulder replacement doesn't work in younger patients or those who do high-impact sports like football due to the risk of rotator cuff injury during Labral repair and Glenoid revision.
Aside from the risks linked with anesthesia and infection, several possible adverse effects are associated with reverse shoulder replacement surgery, including Joint dislocation or partial dislocation (Subluxation), joint instability, Bone fracture, and Blood vessel or nerve injury.
A physician specializing in orthopedics will replace the natural bone in your shoulder's ball and socket with a metal or plastic substitute. It's a major surgery that you'll need to stay in the hospital for several days. Following that, you'll need weeks of physiotherapy.
A reverse total shoulder replacement is more successful for cuff tear arthropathy because it uses different muscles to move the arm. The rotator cuff muscles aid in a range of motion positioning and power in a healthy shoulder.
The majority of individuals receive a standard total shoulder replacement. On the other hand, reverse total shoulder replacement is more successful in treating individuals with certain ailments, such as rotator cuff damage. Even though a conventional shoulder replacement may still cause you discomfort and restricted mobility, if you have this type of condition, it's possible that it will help.