Reverse Shoulder Replacement

Reverse shoulder replacement is an advanced surgical procedure designed for patients with severe shoulder damage, particularly when the rotator cuff muscles are no longer functional. Unlike traditional shoulder replacement, the reverse technique switches the positions of the ball and socket, allowing other muscles, primarily the deltoid, to power the shoulder.

At Iowa Ortho, our fellowship-trained orthopedic surgeons specialize in reverse shoulder replacement to restore pain-free mobility and improve the quality of life for patients with complex shoulder conditions.

What is reverse shoulder replacement?

In a standard shoulder replacement, the natural anatomy is replicated: a metal ball replaces the humeral head, and a plastic socket replaces the glenoid. In reverse shoulder replacement, the positions are switched:

The metal ball is attached to the shoulder socket (glenoid)
The plastic socket is attached to the upper arm bone (humerus)

This design allows the deltoid muscle to compensate for a deficient rotator cuff, giving patients greater strength and range of motion despite severe muscle damage.

Who is a candidate?

Reverse shoulder replacement is typically recommended for patients with:

Rotator cuff tear arthropathy (arthritis combined with massive rotator cuff tear)
Severe shoulder arthritis with rotator cuff damage
Complex shoulder fractures in older adults
Failed prior shoulder replacement surgery
Persistent shoulder pain and limited mobility that affects daily life

Your surgeon will evaluate your shoulder through physical examination and imaging to determine if the reverse approach is appropriate.

Benefits of reverse shoulder replacement

Restores shoulder function when the rotator cuff is non-functional
Relieves chronic pain from arthritis or cuff tear arthropathy
Improves strength and range of motion
Provides a long-lasting solution for severe shoulder damage
Can improve the ability to perform everyday activities, like reaching overhead

The procedure

Preparation: The patient is placed under anesthesia, and the shoulder is surgically exposed.
Surgery: Damaged portions of the shoulder joint are removed, and the metal ball and plastic socket are implanted in reverse positions.
Closure and recovery: The incision is closed, and the shoulder is immobilized in a sling to protect the repair while healing begins.

The procedure typically takes 1–2 hours, depending on complexity.

Recovery & rehabilitation

Recovery is a critical part of successful outcomes:

Immobilization: The shoulder is typically in a sling for 4–6 weeks.
Physical therapy: Gradual exercises strengthen the deltoid and restore mobility.
Activity restrictions: Patients avoid lifting heavy objects or overhead activities until cleared by your surgeon.

Most patients experience significant pain relief and improved daily function within months, with continued improvements over a year.

Why choose Iowa Ortho for reverse shoulder replacement?

Experienced orthopedic surgeons specializing in advanced shoulder procedures
Comprehensive pre- and post-operative care plans
Access to minimally invasive techniques when appropriate
Personalized rehabilitation programs to maximize outcomes