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A shoulder replacement surgery is performed on patients who have severe shoulder arthritis, and have failed nonoperative treatments for this problem. However, a total shoulder replacement, replacing both the ball and the socket of the joint, required the rotator cuff to be working. Patients who have chronic rotator cuff tears tend to have problems with a total shoulder replacement.

A newer procedure called a reverse shoulder replacement has been developed for these specific patients who have shoulder arthritis in association with chronic rotator cuff tears. It is called a reverse shoulder replacement because the ball and socket are reversed; the ball is placed on the shoulder blade and the socket is placed on the top of the arm bone. This reverse technique allows better function with there is a non-functioning rotator cuff.

Comments
November 9, 2007 at 4:47 pm
(1) Kathy says:

My daughter is 21 years old and had a total reverse shoulder replacement last week. So far so good. This procedure is usually done on older folks, so her case will be special. Any advice?

November 12, 2008 at 4:14 pm
(2) Kim says:

I am thinking about having a Reverse Shoulder Replacement. I have had 8 previous surgeries and am 30 years old. I’d like to know how any young person who has this has done. My issues are rare as well as the original injury so I know not to expect too much. Any information would be great.

January 20, 2009 at 3:47 pm
(3) Liz says:

My husband is scheduled for reverse shoulder replacement on 2/17/09. He is 50 with a prior failure of a HemiArthoplasty. We are just trying to get rid of some of pain because right now it is so bad. How is the 21 old doing. Did it reduce the pain.

February 11, 2009 at 11:44 am
(4) Kathy says:

My daughter who was 21 when the surgery was done has had problems due to the fact that the right arm with the replacement is almost 4 inches longer than the left. Apparently, these come in “standard” sizes, but these are usually for men. This has caused nerve damaage from stretching muscles, tendons, nerves in this area. You can now see the replacement through her skin b/c the muscle mass is gone. My opinion: this type of surgery should be a last resort.

April 8, 2009 at 5:32 pm
(5) lineman says:

I had a total shoulder replacemen done May 5 last year. It did not work so the dr hat to do the reversal last week. At first he said everything woulb be back close to norm. Then when he came in after surgery he told me that my shoulder was in wore shape than he thought it would be. Now he tells me that I have to quit work and get on disability because he don’t think the shoulder will hold up to any kind of truma. He did say that this was a last resort surgery and that normally they don’t do this unless you are sixty plus years old. I am only 49. Just hope I qualify for disability. Have been in construction work for 28 years.

September 22, 2009 at 12:19 pm
(6) Kathy says:

Lineman, I hope you qualify for disability. My daughter is still in quite a lot of pain, and the doctors seem to think she will be on pain killers the rest of her life. Naturally, she is worried about addiction to prescription medication. Perhaps the FDA needs to “relook” at this type of surgery and limit its use to those it was originally intended to be used on.

January 12, 2010 at 2:13 pm
(7) Kathy says:

Liz, what happened with your husband? My daughter is now 24 and will be in pain the rest of her life. Painkillers now do her little good when her arm “freezes up” or there is a weather change. Cold really affects her terribly. We are still looking for answers. The statue of limitations is over, or we would be seeking compensation.

May 3, 2010 at 12:04 am
(8) Annie White says:

I have had 4 rotator tendon repair surgeries (severed tendons, not just tears) but am still in pain when I use my arm for most everything. No pain if I don’t move it. My surgeon said last time I saw him that if my shoulder didn’t improve in next 3 months, that I would mostly likely be looking at reverse shoulder joint replacement. I am 67 yrs old and before this last surgery was still competing in sports, such as tennis, beach volleyball, golf & bowling. I’m not ready to give up playing these sports yet….but from everything I’ve read on internet, it sounds like I would be very limitied as to just doing normal activities not to mention anything athletic.
Can any of you offer me info on athletics after reverse shoulder joint replacement?

November 12, 2010 at 2:25 am
(9) Gracie says:

Though my doctor has told me I have no choice but the reverse shoulder replacement, at age 50 I have yet to hear anything great about it. I will stick with the discomfort and limited movement I have until some happy customers beging blogging on their positive experiences.

January 4, 2011 at 6:30 pm
(10) Brian C says:

I am 45 years old and have both left and right Reverse shoulder impants. My best advise is, make sure your PT person is confident in helping you. I had one person be too agressive and caused my total shoulder to fail within a years time. I travel 1.5 hours each way for PT. This person worked on my right shoulder and did a super job, so he will be the only person to touch my left shoulder. 3 hours of travel is worth having a working arm.

October 24, 2011 at 9:58 pm
(11) russ says:

Underwent athroplasty 3 years ago then fell and implant came loose. Iam sick all the time and exhausted from infections and from having to go bavk on pain killers . Having Total Reverse surgery soon . Rotator cuff Athropathy and arthritis in shoulder . age 53-must do this now before Deltoid degenerates .

March 20, 2012 at 3:57 am
(12) marc says:

I had a total shoulder replacement, and then a revision both lasting a total of about 16 years. My rotator cuff was so badly damaged that the only choice I had was the total reversal. SInce the glenoid was eroded, bone was needed from my hip and placed into the glenoid to make it stronger. The hip pain was brutal for about 4-5 months. The shoulder was in a sling for 6 weeks when it was discovered that the glenoid implant moved. Back into the hospital 4 months later to have the glenoid restrengthened by use of a ring around the hip transplant bone as it moved upward. The second reversal is now in a position where the glenoid is out of position again. I am at my wits end. I have a great surgeon, but I am just devastated. Anyone have any ideas as what to do next? I should never had the shoulder messed with in the first place. My life has been a real “bummer ” the last few years. I am 66 and active. Cannot raise the arm above my shoulder height and never with it straight. Am I doomed??

September 17, 2012 at 4:36 pm
(13) Jack Makinson says:

After 2 previous arthoplasties, 1 was a hemi but the humeral implant started to unscrew and then a traditional stem was installed but developed severe adhesive capulitis and a low grade infection set in and extreme pain.The 1st 2 surgeries had not effected the glenoid side of the joint but started to erode from the the last surgery. I was in so muuch pain they prescribed Dilaudid and Fentnyl to overcome the pain and works well but they make me constipated alot. On October 1st this year they’ll do a total reverse arthoplasty and if there isn’t enough bone stock on the humeral head they’ll have to fuse the joint. I feel for you all that have this proceedure and good luck.

January 8, 2013 at 5:16 am
(14) kim stapleton says:

In a couple of months i am having a reverse shoulder replacement,, I am only 47 years of age.. I have a fantastic surgeon now after 3 failed ops. not my now surgeons fault. this operation is my only alternative left to me besides having it fused permanently. I have read above comments with some reservations. Would like to know if there is anyone that could give me some positives to loo forward to?

February 7, 2013 at 1:22 am
(15) Matt DeLuca says:

Kim, I had to get a reverse shoulder replacement last May due to 50% bone loss in the shoulder, bad arthritis, and a completely atrophied rotator cuff muscle from nerve damage. I have put myself through extensive rehab/weight training since then. 9 months later I am working out 7 days a week and playing hockey again (no one thought i would even play again).

After finding the right doctor to perform this surgery, the biggest key to how much function you get back is all up to you. How much you want it and motivation and sticking with it and not giving up. I’m not going to lie, the pain for the next couple weeks is horrible. Just be strong through that period of time and push yourself afterward to get it back and you’ll do great

March 14, 2013 at 6:07 pm
(16) Toni says:

Kathy –

How is your daughter doing now?? I can for sure relate!! I had my shoulder replacement at the young age of 22 years old. I am now 31 and have pain almost everyday! It is a lot worse in the cold and damp weather! I have had 6 surgeries on my shoulder. My 4th one was my shoulder replacement. I was on HEAVY pain medication for about 2 years and it took a treatment team to help get me off of them! That was NOT fun but I did not want ANYTHING to do with horrible pain meds! Once I stopped the strong pain meds I started taking advil liquid gels. They actually REALLY work. For about the first year I was taking 6 at a time a couple times a day, every year I went down a pill and it slowly helped! Now I am down to taking 3 every few days, sometime I can actually go a week without taking anything! Yay!! I would advise you and your daughter to try taking a little less at a time. I know it is hard and I know that I will have the pain for the rest of my life as well but I just need to deal with it. It could be a lot worse.

It is very very heartbreaking that so many young people have to suffer from this. I wish I never even got the very first surgery when I was 17 years old and I would probably be fine. But I cannot go back and I cannot dwell. All I can do is move forward and try to be positive. I have found that getting massages, taking baths, advil, and not laying directly on my arm has helped the most!

I wish her well! Contact me if you want. tkarpp@yahoo.com

March 17, 2013 at 10:58 pm
(17) sheila says:

I had a total reverse shoulder implant done a little over a year ago , the pain never really went away in the last six months there has been an increase in pain to my shoulder it is so bad that I throw up . I am afraid that something is wrong with the implant . I am calling my surgeon , but it takes about 2 months to get an appointment . I hope it is jsut some type of nerve damage as I don’t want to have surgery on it again way to painful . Has anyone else had this type of problem ?

March 24, 2013 at 2:04 pm
(18) Paul says:

As many of you have asked, are there any more positive results from a reverse shoulder replacement. I have already had a standard rotator cuff surgery, then a right pec major transfer. I’m concerned about dislocation of the ball from the socket and instability . A report I read online reports 25%-50% complication rate for this procedure.At 68 years old all I feel comfortable about is being in the right age group.

March 28, 2013 at 8:56 pm
(19) Ann says:

I had a reverse 3 weeks ago, 6th surgery in 3 years, following failed cuff repair, failed hemi and failed tsr. The cuff is gone except for the teres minor. I am 57, my lifelong passion is/was horse riding. The humerus had to be split to remove the stem, and then the tuberosity broke during removal, so i am immobilized now. We will see, considering how this went, my expectations are low. This was the result of an accident.

March 29, 2013 at 2:14 pm
(20) Paul says:

Ann, Hope your recovery is speedy and your results exceed your expectations. Paul

March 29, 2013 at 5:26 pm
(21) Ann says:

By the time we get to the reverse option, there have to be some very serious issues and problems we are facing. We are starting at the bottom, so to speak. This is a highly technical, difficult and “salvage” procedure done when there is nothing left to do.

My surgeon was very hesitant to do it, and insisted I see another top specialist for another opinion. All he would say is that he hoped I will be able to touch my head and have less pain. As a second revision procedure, the odds are stacked against me.

I was prepared for problems with infection, or needing a bone graft. I was not prepared to wake up with two broken areas – the humerus had to be split to remove the stem from the tsr, then the tuberosity broke removing it. I was not prepared to hear I lost all of the rotator cuff except the teres minor.

This is not just another replacement, it is last ditch effort to get some functionality. If done as a primary procedure, OK, outcome might be OK. As a second, or, gasp, third revision, complication rates are very high.

My head is still reeling that all this even happened – I am just grateful I have a surgeon who continues to help me, and is totally and completely honest about my chances.

May 30, 2013 at 7:53 pm
(22) Lisa says:

Oh dear, I am 45 and scheduled for a reverse in 3 week’s time, after 8 massive surgeries to my R shoulder, following an assault by a patient at work 7 years ago. I also had hamstring transplants (grafts) to the shoulder. I am now left with 3 of my 4 rotator cuff tendons shredded, end stage arthritis (ball and socket) and severe avascular necrosis of the entire humeral head. Worst for me is that I very nearly dies x 2 during shoulder surgery, the last one 18 months ago. My heart failed and they still don’t know why. To say that I am mortified of the reverse surgery would be an understatement. But living in extreme pain and debilitated is not a quality of life either, I am in bed every afternoon from pain. My back is now also lopsided because the shoulder is continuously dislocated (upwards and forwards). My surgeon, a top upper limb specialist, has always been very conservative with the past surgeries, attempting to repair as best as possible (i.e. grafts). However he has now told me that I have no option other than the reverse. The longer I stay as I am the more likely the reverse will fail as my shoulder blade is malfunctioning and my deltoid is wasted.It will also be harder to get my back sorted in rehab the longer I walk around lop-sided. I have been reading about the reverse and am totally mortified about the high rate of complications and failures, especially in younger people. What if it goes wrong? it is such a difficult decision to make and I really wish there was a little more positive feedback here! Any thoughts?

June 18, 2013 at 9:04 am
(23) Paul says:

Hi Lisa, I had a total reverse shoulder replacement on June 5th. Stayed in the hospital 4 days and have my first doctor visit this afternoon. I really thought it would be worse but I’m still taking pain killers and being very careful with my movements. Had two prior shoulder surgeries but nothing as complicated as yours. I’m not expected to lift more than 10lbs in order to keep the hardware in good condition. Wish I could say more about the pain but as I ease off on the meds I’ll let you know. Hope everything goes well for you. Paul

June 26, 2013 at 9:58 pm
(24) Ann says:

Lisa,
How are you doing? And Paul?
I am 3 months out from my reverse. It has been a rough road, but am finally seeing some improvement. My pain doc says that I may never be painfree, but it is getting better. My range of motion is better as well. I am satisfied, and give a lot of credit to my surgeon. He took my case when no one else would, and while the surgery did not go as expected, It is OK. Some of us are not so fortunate, but with the reasonable expectations and support of medical docs and pain management, it can work. I also use reiki, healing touch, and other alternative remedies to find comfort.

I have no tendons left either but the teres minor, and the anterior deltoid is atrophied. I thought a reverse could not be done if the deltoid is wasted. I had an EMG and the nerves were firing, so we went ahead. I hope it goes well fir you both.

September 10, 2013 at 7:57 am
(25) anxious says:

I had a reverse end of May this year. I needed pain medication for a week. Have been doing dayly excersizes in the pool. Can lift my arm straight up without help. Even rotation is fine in the front back still stiff Muscles around the shoulder need strengthening but I am not allowed to do more before my next visit to the doctor in October. Horse back riding has always been my passion and I do hope it will be possible in the future. Hearing about all these bad experiences makes me a bit apprehensive. Does anyone have good experiences? Has anyone gone back to horse back riding? How long did you wait?

September 19, 2013 at 6:32 am
(26) Ann says:

My surgeon about choked when I asked him if I could ride again. I have 3 horses. He is very adamant that I never ride a horse or even a bike. But mi reverse was a revision, very serious complications, still have limited function.

September 23, 2013 at 6:37 am
(27) Alessio Ventura says:

I had a total shoulder replacement in March 2011, followed by a reverse total shoulder replacement in May 2012, which became necessary when I fell on my shoulder after the first replacement. After the reverse total shoulder replacement (RTSR), I had physical therapy in the home. After a week of therapy, the pain was increasing, not decreasing, so I went in for an x-ray. The surgeon who had done the RTSR studied the xray and determibed that I had a fractured Greater Tuberosity. He said it was likely my fault because I had been moving my arm.

Now, is it unheard of to have a Greater Tuberosity break post RTSR, or is it not unusual? It was very painful and it extended my recovery for a fair amount of time.

I still have great pain in the shoulder as of Sep 2013, but the surgeons cannot see anything obvious as the fracture has since healed on its’ own, and the fluid xtraction (with flush) that they cultured is negative for infection. The pain is constant at about a Level 5 on a 10 scale. One theory is that impingement occurs with certain movements, either on tissue or bone; if on bone the pain will subside over time as the bone is scraped.

Can anyone out there suggest something? The pain is enormous and I cannot concentrate at work. HELP!

September 24, 2013 at 9:22 am
(28) Ann says:

Your story is very similar to mine, only my greater tuberosity was fractured during the revision from the tsr. My reverse was 6 months ago, since the pec and deltoid are atrophied, i am not bothering with pt anymore. I qualified for long term disability through my employment benefits. The pain is expected to be chronic, and there is really nothing further to be done, nor do I want any further surgical intervention until something goes wrong.

I would suggest pain management through a qualified PM doctor. And no way did you fracture your own GT. maybe it was weakened/fractured during the revision, but you could not have done that by moving your arm!

January 9, 2014 at 11:36 am
(29) Paul says:

The TRSR I had in June was removed the end of Sept. as I got a one in a million bacterial infection .It was replaced with a resin shaft and cup impregnated with anit biotics and left unattached at the top. Four days in the hospital and a pic line in my arm and a shoulder pack of antibiotics to wear 24 7 for eight and a half weeks. Had home visits weekly to change pic line tubes and take blood etc. Pic line is now out and blood work says infection is gone. Have mid Jan. appt. for ultrasound and aspiration of any remaining fluids before the TRSR replacement on Feb. 19th. The aspirated fluid will be grown in the lab just to be certain no bacteria remains. This will be my fifth surgery and better be the last.Hope everyone out there is doing better than me but I have hopes I’ll pull thru and regain lots of shoulder use as time goes on.

January 11, 2014 at 8:21 pm
(30) Ann says:

Wow Paul that is really an ordeal! I know it happens, glad i dodged that one even though i had a positive p.acnes culture after my conventional replacement. I am almost 11 months out from the reverse and the pain is as bad as ever. Will be heading back to the east coast to see my surgeon. I know there is nothing to be done, but I would like to know if anything is wrong. Or maybe it is time to change up the pain meds. Any activity is too much for that arm.

January 13, 2014 at 2:25 pm
(31) Paul says:

Hi Ann, Sorry your pain is still a problem, you never know what your doctor may find. Glad you dodged the p.acnes, my aspiration is Wed. and it better be gone. Looking foward to being attached at the shoulder again as everything hurts these last few months.The best of luck to you.

January 18, 2014 at 10:20 pm
(32) Ann says:

After six surgeries, i don’t care all that much any more. I know there will be more, sooner or later. At least i won’t have to deal with PT as the rotator cuff is nonexistent, and most surrounding muscle is atrophied. It is what it is. Infection is the worst complication in my viewpoint.

I know more than a few people who believe surgery after surgery will being them back to 100% normal. That is impossible. At this point, we are just trying to keep our heads above water.

Best wishes to you!

January 21, 2014 at 12:34 pm
(33) Bonnie Peters says:

Wow, I just had a total reverse done on 12/27. So far so good. I have taken no major pain medication and haven’t even taken Aleve for over a week or two. It hurts some when I do certain exercises (certainly not unbearable), but that pain goes away as soon as I am done with the exercise/therapy. Being it is only 4 weeks since my surgery, I feel fortunate and blessed. I had had a rotator cuff surgery 6 months ago, but the muscles were too badly torn so didn’t hold. At this time, I am grateful for the surgery. I can lift my arm over my head, which I couldn’t do with the rotator cuff surgery. I had a great surgeon in Bozeman (Bridger Orthopedics – Dr Vinglas) and after reading the other experiences, I have to really give God thanks for His help. I just thought this was the way to go, after reading the others, I will think twice before recommending it. I am 72 years old and in great health. I hope others have had as good of experience as I have had.

January 21, 2014 at 3:20 pm
(34) Ann says:

It is wonderful you are doing so well. Please do not hesitate to tell everyone of your great outcome! I was doomed due to the history of multiple unsuccessful prior surgeries and 2 revision replacements, and some serious mistakes. Unfortunately I did not find my star surgeon till the end when I was too far gone to have a good outcome. Plus it began with a severe injury. I am “only” 58.

January 24, 2014 at 9:49 am
(35) Marie H says:

I am shocked at all the problems you all have had with shoulder replacements. I had my right shoulder replaced in Sept 07. After 8 weeks of intense PT I was doing so well I forgot about being more careful. At 12 weeks I yanked my 80# Golden on the lease in an upward bent arm motion and did some damage. We tried more PT for the next 3 months and nothing helped. My surgeon went back in and released the torn Biceps Tendon and did some other things and also at that time removed the ball he had initially put in and replaced it with a smaller ball for better movement. Since recupeing from that May of 08 surgery I have been golfing up to 150 rounds of golf a year with no pain. Full ROM. I was never on pain meds longer than 7 days after either surgery. However, I am now starting to have some discomfort in the muscles around the joint, but after 6 years of golf etc, I can’t complain. I am 71. My brother had the same surgery and we both had the same surgeons with no problems or pain and 90-100% ROM. Dr Barry Smith Billing Clinic Billings, MT

January 25, 2014 at 11:48 am
(36) Ann says:

The poorer outcomes are the result, in most cases, of very complicated injuries or circumstances, and multiple previous surgeries. If one goes in with a relatively “clean” record, results are typically very good. Those with complex cases generally have the problems. Be thankful! I give my current surgeon credit and kudos for taking me on as a patient when others would not due to the complexity.

January 26, 2014 at 4:16 pm
(37) julie b says:

I have had 2 rotator cuff tear surgeries, one in March of 2013 & one in Aug of 2013. I still am in pain and unable to lift my arm. I just had another MRI last week and there is still a full thickness tear and my muscle is atrophied. My Dr. has recommended a Latissimus Dorsi Transfer, or a Reverse Shoulder Replacement. I am 48 years old. I am so confused and have no idea what to do.

January 27, 2014 at 6:30 am
(38) Ann says:

Get at least 2 more opinions. From the best shoulder surgeons you can get to.

April 23, 2014 at 4:06 pm
(39) Tammey says:

I am 47 years old and was involved in a accident with shattered shoulder and crushed artery. The bone died due to the lack of oxygen and had a total shoulder replacement done. Do to the amount of nerve damage I was never able to get ROM back. 3 years later I am in terrible pain and had CT scan done to be told that my shoulder was dislocated and eroding the bone I do have left in shoulder. I am scheduled for a reverse in a couple of months and was told with all of the damage done to my arm during the accident that this was a salvage operation. I wish I knew what to expect because I am a very active person, zip line, ATVing, shooting sports. I was told that most likely the pain will subside and I will have more ROM after the surgery but I am starting to doubt that will happen since I have read the prior surgeries. :(

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