More and more, people that I know have had reversed shoulder replacement surgery. Let me explain what the difference is between “normal” shoulder replacement versus reversed shoulder replacement. Before, when your shoulder needed a replacement due to extreme wear and tear of the cartilage and bone, an orthopedic surgeon would saw off the ball of the humerus (upper arm bone) and put in a replacement of the ball in the top of the humerus. Then, surgeon would put a synthetic socket in the shoulder blade so the ball could move smoothly in the joint.
The challenge with this surgery is that the shoulder joint is a very complicated joint. It can raise forward and up, it can raise sideways and up, it can raise backwards, it can circle (circumduction). And the main part of the muscles moving your shoulders are the deltoids, the outer part of the shoulder muscle. It’s divided into 3 major sections: Anterior (front), lateral (side) and posterior (back). Below the big muscle are the rotator cuff muscles (many people have heard about it, and a big reason for shoulder surgery in younger people due to injury, or older people due to wear and tear). The rotator consists of 4 smaller muscles: supraspinatus, infraspinatus, teres minor and subscapularis. They help with inward rotation, outward rotation and assist the lifting arm.
With the traditional replacement surgery, all those muscles have to be re-attached to make sure the shoulder joint can move correctly. Reversed shoulder replacement surgery, which has been around since the 1970s but has been done a lot more after FDA approved it in early 2000, they actually screw the ball to the shoulder blade, and add a socket (which can move on the ball) on the top of the upper arm (humerus). What is so great with this replacement is that the rotator cuff muscles are “by-passed”. With this, the deltoid muscle can move the arm in all directions. Especially for people with bad rotator cuff muscles, this replacement has been a blessing. Personally, I have seen a big uptake in reversed shoulder replacement in the last 10 years. Reverse shoulder replacement has become more popular, and are more common, because so many shoulder sufferers are dealing with bad rotator cuff muscles too. When someone has healthy rotator cuff muscles and need replacement due to accident or injury, the surgeon still does the traditional shoulder replacement, where the ball is attached to the upper arm bone. Do your research before jumping into any surgery. Try physical therapy, it has done wonders for so many people. Talk to your primary doctor and orthopedic surgeon and let them explain what your shoulder needs. With reversed replacement, there definitely will be weight limits on your shoulder exercises. Take this in consideration if you lift heavy weights or do heavy lifting at work.
All in all, the people I know who have had it are doing amazing!
Ester H. Marsh is director of healthy living at the J.F. Hurley Family YMCA.
