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Total Shoulder Replacement: Traditional Versus Reverse

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If you are having shoulder pain resulting in significant mobility issues, a shoulder replacement could be a possible treatment to help alleviate pain and restore, or at least improve, function to the extremity. However, it is important to note that not everyone is a candidate for this course of treatment. Moreover, there are two types of shoulder replacement surgeries -- traditional and reverse total shoulder replacement -- that could benefit those patients who are candidates. Each procedure serves its own purposes and is designed to help individuals with different complaints or shoulder issues.

Traditional Total Should Replacement

The traditional total shoulder replacement involves the repair or replacement of the affected extremity's ball and socket joint after years of degeneration. This surgery involves replacing the ball portion of the shoulder, which is also referred to as the humeral head, with a metal sphere while a plastic or other synthetic apparatus is used for the socket replacement. This type of procedure is most helpful for patients with arthritis and other related conditions, which result in joint problems and missing cartilage.

Reverse Total Shoulder Replacement

Conversely, those patients who have suffered damage to the rotator cuff tendons will likely benefit from a reverse total shoulder replacement. This procedure involves the reconstruction and replacement of the damaged shoulder's ball and socket joint, along with a reversal of its orientation. Meaning, the ball and socket are switched or reoriented from how they occur naturally.

By reversing the orientation, this should help to stabilize the damaged joint, which will result in better range of motion, improved function, and pain control. This procedure is most helpful for patients who have endured a traumatic injury or developed significant rotator cuff issues and pain over time. Problems of this nature may be attributed to a rotator cuff tear or injury that surgery failed to remedy, massive rotator cuff tears or injuries which cannot be fixed, or significant rotator cuff issues coupled with the development of arthritis. These shoulder impairments are often characterized by significant (even chronic) pain, lack of power with movement, and limited or restricted range of motion.

Complications

Possible complications of these procedures are similar to those of any joint replacements in the body. These may include infection, dislocation, defective materials, loosening of the replacement apparatus, or the need for revision surgery. Additional complications that are rare but unique to these two procedures could involve significant and long-term neurological and vascular damage.

Recovery of Traditional Total Shoulder Replacement

Both procedures typically require hospitalization and patients can expect to stay a few days. With a traditional total shoulder replacement surgery, movement of the extremity should be limited during the early recovery stage. This convalescence allows the repaired joint to begin the healing process and gives the cement used to adhere the components ample time to heal.

Recovery of Reverse Total Shoulder Replacement

With the reverse total shoulder replacement procedure, however, some range of motion exercises are encouraged and recommended. This is fostered to introduce the new arrangement of the joint to its host body. Moreover, the recovery time for the reverse procedure is often faster than that of the traditional total replacement surgery and standard rotator cuff repairs. Furthermore, both procedures require 2-3 months of intensive physical therapy, followed by a home rehab program for at least 6-12 months after the surgery.

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