Your shoulder is made up of a ball and socket joint, where the ‘ball’ of your upper arm bone (humerus) fits into the ‘socket’ (known as the ‘glenoid’) of your shoulder blade. If this joint is damaged, particularly through the wear and tear of osteoarthritis, a shoulder replacement may be necessary.
In a standard shoulder replacement, an artificial ball and socket joint is created using metal and sturdy plastic. A healthy rotator cuff (the group of muscles and tendons surrounding the shoulder joint) is needed, as the new ball and socket joint requires these muscles and tendons to keep it in place. If these tendons are damaged or torn, as can happen with osteoarthritis, an alternative approach is used which relies on other muscles to support the new joint, such as the deltoids (back muscles).
Your orthopaedic surgeon may suggest a reverse shoulder replacement for other reasons, such as:
- Having previously had a shoulder replacement that has since failed,
- Having severely fractured your shoulder,
- Having chronic shoulder dislocation,
- A tumour on the shoulder joint,
- Being unable to move your arm above your head.
For a reverse shoulder replacement, an artificial ball and socket joint is again created with metal and plastic, but in this case the metal ball is placed on the socket side of your shoulder, and the plastic socket is attached to the top of your humerus, ‘reversing’ the joint. By bypassing the use of the damaged tendons and muscles in your rotator cuff, this procedure allows other muscles around your shoulder, such as the deltoids in your back, to support the joint, restoring your range of motion and helping to eliminating your pain.
The aim of a reverse shoulder replacement is to attach the new artificial ball and socket joint, reversing the standard positioning of the ball and socket so as to create a stronger bond, allowing you to restore and regain the function of your shoulder. The surgery typically takes between one and two and a half hours, and our multi-disciplinary teams within all our Circle Hospitals will be on hand to care for you before, during, and after your operation.
Prior to your surgery, your orthopaedic surgeon will thoroughly review your most recent X-rays and diagnostic scans, and will mark the appropriate shoulder site in preparation for surgery, finalising plans to ensure the operation is as safe and efficient as possible. They will also spend time with you at this stage to talk you through the procedure and answer any questions you may have. Many of our patients find this helps put them at ease prior to undergoing the operation.
As the operation will be carried out under general anaesthetic, our specialist anaesthetists will assess you and provide the necessary level, combining the general anaesthetic with a local anaesthetic which is injected directly into your affected shoulder. They will then monitor you closely throughout the procedure and check on your wellbeing after completion.
In the operating theatre, your orthopaedic surgeon will first make an incision at the front of your shoulder to allow access to the joint. Using specialist equipment, the head of the humerus and the glenoid will then be replaced with the metal ball and plastic socket, and cement and/or screws are used to fasten it in place.
After surgery, once the general anaesthetic wears off, you may feel some pain and discomfort as your shoulder starts to heal. This is to be expected following an operation like this, but our dedicated team will be monitoring you regularly to make sure there are no complications and to help manage your pain as best as is possible. Only when our experts are fully satisfied that your level of pain is under control will they discharge you home.
You will usually need to rest your arm for four to six weeks in a sling with minimal movement of the joint during that time. Our physiotherapy team will see you regularly, providing you with specific exercises to help strengthen the muscles around the new joint and to increase your mobility. It can take several months for the pain to subside and mobility to be restored, but you should notice that the pain is considerably less than before your operation.
If you’ve been battling pain and stiffness in your shoulder, why not speak to one of our team members and book an appointment to see one of our specialists? They will be able to see you at a time of your convenience, where they can diagnose you and start any necessary treatments promptly, easing your mind and enabling you to start your road to recovery.