The most advanced type of shoulder arthroplasty, particularly for severe damage and fractures, both in Europe and the U.S., is considered to be the reverse total shoulder arthroplasty. It offers solutions even for the most complex shoulder problems.

Thanks to innovative techniques and the assistance of digital technology (special software and navigators), the procedure is personalized, tailored to each patient’s unique anatomical needs, and can provide faster and more definitive pain relief.

Total Shoulder Arthroplasty and Reverse Total Shoulder Arthroplasty

Shoulder arthroplasty is a surgical procedure where the arthritic and damaged joint surfaces of the shoulder are replaced with artificial implants. This operation is typically recommended for patients with advanced arthritis who have exhausted all conservative treatment options. Its goal is to relieve pain, restore range of motion, and improve joint function, thereby enhancing the patient’s quality of life.

There are two main types of shoulder arthroplasty: total shoulder arthroplasty and reverse total shoulder arthroplasty. The latter is increasingly used worldwide by shoulder surgeons because it offers solutions even for clinically challenging cases.

Who Is a Candidate for Reverse Total Shoulder Arthroplasty?

This procedure is primarily indicated for patients with severe osteoarthritis of the shoulder accompanied by irreparable tears or deficiency of the rotator cuff tendons (rotator cuff arthropathy). It is also used in certain types of complex fractures that cannot be treated by other means (such as osteosynthesis), and for revision of failed prior shoulder arthroplasty. In such cases, the conventional procedure would not significantly improve shoulder mobility.

What Is Reverse Total Shoulder Arthroplasty?

Reverse total shoulder arthroplasty involves replacing the shoulder joint with an artificial prosthesis that reverses the normal anatomy of the shoulder, due to rotator cuff deficiency. Specifically, the normal ball-and-socket joint is reversed: the spherical head becomes concave, and the glenoid, which is normally concave, becomes convex. This creates a stable joint that can function even when the tendons are severely damaged.

Preoperative Planning

Before surgery, the patient undergoes a CT scan of the shoulder. The results are used to create a 3D model of the patient’s unique anatomy, and with the help of specialized software, the orthopedic surgeon plans the operation. This allows the exact placement of the implants to be determined in advance, ensuring a perfect anatomical fit.

How the Reverse Shoulder Arthroplasty Procedure Is Performed

Using minimally invasive techniques, the specialized orthopedic surgeon makes a small longitudinal incision on the shoulder, avoiding damage to the muscles and tendons that are vital to shoulder function. The damaged surface is located, removed, and replaced with the special prosthesis.

To ensure the precise placement of the prosthesis components, 3D-printed patient-specific guides may be used. Additionally, digital navigators can be employed to assist in accurate positioning of the implants.

The patient can usually get up shortly after surgery, once the anesthesia has worn off, with immediate arm mobilization, and may return home within one day, depending on their clinical condition and medical history.

What Is the Prosthesis Made Of?

The artificial prosthesis is made of biocompatible, highly durable materials designed for long-term results.

Recovery

In the first few days postoperatively, the use of a special shoulder brace is recommended along with simple daily mobilization exercises that help relieve discomfort.

Stiffness and pain present before the surgery usually subside within the first weeks of recovery. Afterwards, the patient follows a comprehensive rehabilitation program with a physiotherapist to restore shoulder movement, stability, and muscle strength.