Reverse Shoulder Replacement

Reverse Shoulder Replacement Overview

Shoulder arthritis occurs when the cartilage of the ball and socket joint begins to wear away. Symptoms of shoulder arthritis include persistent pain, inflammation and swelling. Patients suffering from advanced shoulder arthritis who have tried conservative treatments without relief may be candidates for total shoulder replacement or reverse total shoulder replacement.

Every year, thousands of shoulder replacements are successfully done for patients who have shoulder arthritis, many performed by Dr. Peter Millett. Patients who need a total shoulder replacement and have a large rotator cuff tear – or who have developed a complex type of shoulder arthritis called “cuff tear arthropathy” – may be a candidate for reverse shoulder replacement.

Reverse shoulder replacement may be recommended if you have:

Cuff tear arthropathy
A torn rotator cuff that cannot be repaired
A failed total shoulder replacement
Severe shoulder pain and difficulty lifting your arm away from your side and over your head
Failure of non-surgical treatment options such as physical therapy, medications, cortisone injections and rest

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In a reverse TSA, the normal anatomy of the glenohumeral joint is reversed. This is achieved by replacing the glenoid (socket) with a prosthetic ball and the humeral head (ball) with a prosthetic socket.

A shoulder replacement mimics the normal anatomy of the shoulder by using a “cup” that is fitted into the shoulder socket (glenoid) and a metal “ball” that is attached to the top of the upper arm bone (humerus). With a traditional shoulder replacement, the rotator cuff muscle helps to position and power the arm during movement (Figure 1). When patients do not have a functioning rotator cuff, traditional shoulder replacement will not work and may result in persistent pain,limited range of motion, or early loosening of the implants.

Pre-Operative

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For patients with a compromised rotator cuff, a reverse shoulder replacement is used (Figure 2). This implant creates a new stable fulcrum so that the deltoid muscle can power and position the arm. While the same ball and socket are replaced, they are positioned in ‘reverse.’ The procedure and implants are changed so that the ball is on the socket side of the joint and the socket is on the ball side of the joint. With this set up, the deltoid muscle can now power the arm instead of the rotator cuff, eliminating pain and restoring function.

Post-Operative

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Reverse Shoulder Replacement Procedure

An interscalene nerve block is used to numb the shoulder and arm. Dr. Millett makes an incision over the front of the shoulder and removes all the arthritic bone, bone spurs, and tight scar tissue. The metal ball is then positioned and secured into your shoulder socket and a patient-specific stem with a new socket is then secured into the upper arm bone.

Reverse Shoulder Replacement Video Demonstration

Reverse shoulder replacement is a relatively new procedure and highly technical, which is why it is important you have a skilled surgeon performing this procedure. Dr. Millett has been performing this procedure since 2004 when it was first approved by the FDA for use in the USA and continues to have extremely successful results. He was among the first surgeons in the US to be approved to use this new implant. Reverse shoulder replacement has been used in Europe since the late 1980’s, and Dr Millett has performed close to 1000 of these surgeries.

Recovery After Reverse Shoulder Replacement

After surgery, our medical team will provide pain medication to help manage the pain along with buying Doxycycline online antibiotics to prevent infection. During your time at the hospital you will begin initial physical therapy. Simple sets of exercises will be taught so that you can continue them at home.

Most patients are likely to go home on the first or second day after surgery. Your arm will be in a sling for about 3 weeks when you leave the hospital. It is very important to follow the prescribed physical therapy to help improve strength and range of motion. Full recovery is typically achieved by 3-4 months post-operatively.

For additional details on shoulder arthritis, or to determine if you are a candidate for reverse shoulder replacement, please contact the office of Dr. Peter Millett.

Am I Candidate for Shoulder Replacement Surgery?

What is my Alternative to Shoulder Replacement Surgery?

What are my Treatment Options for Shoulder Osteoarthritis?

What Options Exist for Young Patients with Osteoarthritis of the Shoulder?

Are you a candidate for reverse shoulder replacement?

There are two ways to initiate a consultation with Dr. Millett:

You can provide current X-rays and/or MRIs for a clinical case review ($250).

You can schedule an office consultation with Dr. Millett.

Request Case Review or Office Consultation

Peter Millett, MD

Average rating:

39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!