Orthopaedic Blog

Standard Shoulder Replacement vs Reverse Shoulder Replacement

27 February 2023 Treatments, Orthopaedics


As new medical techniques develop, it is vital that patients facing shoulder replacement surgery are aware of the options available and the best solution for their specific needs.

Your orthopaedic surgeon will advise you on the suitable shoulder replacement surgical method for your requirements and discuss the details and outcomes. However, this article will briefly review the differences between a standard shoulder replacement surgery and the new, innovative reverse total shoulder replacement method.


Shoulder Replacement Basics


Standard shoulder replacements are relatively well understood by the public, and most people will have someone in their life who has undergone a replacement procedure of this nature.

The shoulder joint is a “ball in socket” joint, where the humeral head (ball) and shoulder blade or scapula (socket) meet. The joint is supported by cartilage, tendons, and muscles. All of which can become injured or worn over time and cause pain.

The bones that form in the joint are held in place by the rotator cuff. The rotator cuff is formed by the muscles and tendons that wrap around your shoulder blade, the top of the shoulder, and the collarbone. They allow you to move your shoulder joint and arm.

Below, we answer some frequently asked questions:


Why Do People Require Shoulder Replacements?


People require shoulder replacements when the shoulder joint becomes damaged, and the ball and socket can no longer operate smoothly. Shoulder replacements remove areas of the shoulder joint that have osteoarthritis (missing cartilage).

Shoulder replacement may also be required after rotator cuff injuries and fractures.

Is Shoulder Replacement Surgery Risky?


Shoulder replacement surgery has a low risk of complications. For the best possible outcomes, it is imperative that patients follow their doctor’s and physiotherapist’s instructions post-surgery.

All surgery poses a degree of risk. However, this procedure is usually very straightforward for our experienced surgeons.


What Does A Standard Shoulder Replacement Involve?


A standard shoulder replacement removes injured or damaged areas of bone in the shoulder joint and replaces it with specially made metal and plastic implants.

This may include replacing the entire ball and socket joint or just the “ball” or humeral head. The ball replacement implant is usually formed using complex metal alloys such as titanium-aluminium-vanadium. Plastic is often used for scapula components. The operation usually takes 2-3 hours.


Reverse Shoulder Replacement


Similarly, to the standard shoulder replacement, in a reverse shoulder replacement, the shoulder joint is replaced with components formed with plastic and metal.

However, the ‘reverse’ in the name refers to the fact that the implanted ball is placed on the socket side of the joint, the reverse direction from that found in a standard shoulder replacement.

Essentially, the ball (the dome-shaped component) faces outward rather than inward toward the collar bone. The socket (the concave component) is then placed facing inward, in line with the ball. The socket implant has a “metal stem” that connects to the humerus bone. The metal stem is fixed to the bone with medical cement.

The reverse shoulder replacement is held in place by screws in the socket implant, which fasten it to the scapula. The ball is then attached to the socket via a connecting plate.


Key Differences between Standard Shoulder Replacements and Reverse Shoulder Replacements


The key difference between a standard shoulder replacement and a reverse shoulder replacement is the type of implants utilised in the surgery.

Standard shoulder replacement – the ball and socket implant mimic the natural shape of the shoulder, with the dome of the ball component facing inward.

Reverse shoulder replacement – the ball and socket implant face the opposite way to the natural structure of the shoulder. The dome of the ball component faces outward.

A Standard shoulder replacement is designed for patients with intact rotator cuff tendons. The tendons in your rotator cuff connect the muscle to the shoulder. The standard shoulder replacement may be unsuitable if these tendons are worn away or snapped.

However, the reserve shoulder replacement is designed for patients that have torn their rotator cuff completely or have severely damaged the tendons.

For those of us more visual learners, review this educational video which outlines the differences between the two implants.


Reverse Shoulder Replacement Surgery Melbourne


Please do not hesitate to contact us if you are experiencing persistent shoulder pain or impeded shoulder movement.

Melbourne’s Orthopaedic Specialists will help you get back to life.

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