Shoulder Replacement (also known as Reverse Arthroplasty) is a surgical treatment used to relieve severe shoulder joint pain. This can be caused by a number of conditions, including arthritis, rotator-cuff tears or failed shoulder surgery.

During reverse shoulder surgery, the damaged components are removed and artificial components are replaced. In traditional shoulder surgery, an artificial joint is used to mimic the natural anatomy of shoulder. A metal ball replaces damaged humeral balls and a socket made of plastic replaces the damaged cavity of the glenoid.

If the rotator muscles are severely torn or damaged, a conventional shoulder replacement may be insufficient because the rotator muscles are crucial for shoulder stability.

Reverse shoulder replacement involves the reversed position of ball and socket components in the artificial joints. The metal ball and plastic socket are attached to the shoulder plates, while the upper end of humerus is attached to a plastic socket.

This procedure can be beneficial for patients who have severe rotator tears, arthritis and irreparable rotator damage, fractures in the upper arm bone or complex fractures.

There are several indications that a total shoulder replacement is necessary.

• Osteoarthritis

Degenerative joint disease is characterized by the breakdown cartilage in the shoulders, causing pain, stiffness, or a decreased range of movement.

• Rheumatoid arthritis

This autoimmune disorder causes inflammation of synovium (the lining of joints), resulting in cartilage deformity and pain.

• Post-traumatic arthritis

Arthritis develops after a severe shoulder fracture or injury, leading to cartilage degeneration and joint degeneration.

• Rotator cuff syndrome

A severe condition characterized by advanced rotator cuff tear with arthritis that causes shoulder weakness, pain and disability.

• Avascular necrosis

A lack of blood supply can cause the bone tissue to die. This leads to arthritis and shoulder joint collapse.

• Shoulder surgery failed before

Patients who have had shoulder surgeries that failed, such a failed rotator repair or shoulder arthroplasty and still experience pain and dysfunction.

• Severe fractures in the proximal arm

Nonsurgical treatment of complex fractures near the shoulder that affect the upper arm bone.

Even conservative treatments like injections, physical therapies, or medications are ineffective for severe shoulder pain.

Surgical Procedure

• Anesthesia

The patient is put under general anesthesia which means that they are unconscious for the duration of this procedure. The use of regional anesthesia (such as nerve blocks) can also provide pain relief after and during surgery.

• Incision

In order to reach the shoulder joint, a surgeon will make an incision along the front of the shoulder or on either side, which is usually a few inches long.

• Preparation for the Glenoid

Specialized surgical tools are used by the surgeon to remove damaged or arthritic tissues from the glenoid, the socket of the shoulder. The glenoid (socket) is prepared to receive an artificial socket component.

• The Humerus is prepared

The surgeon prepares the remaining bone so that the artificial ball portion of the prosthesis can be placed. The humeral component may be positioned lower on the upper arm bone in cases of severe rotator damage. This will optimize shoulder function.

• Implant Placement

The artificial components for the reverse shoulder prosthesis will then be inserted into the prepared surfaces of the bones. The metal ball is attached directly to the shoulder blade. The plastic socket is attached directly to the upper end the humerus. These components are attached using surgical cement, or by pressing them into place.

• Closure

The surgeon then closes the incision and applies sterile bandages to the surgical area.

• Postoperative Care

After surgery, patients are usually monitored in a recovery room until they are transferred to an hospital room or sent home. Physical therapy is an essential part of the recovery process. It helps restore shoulder functionality, strengthens the surrounding muscles and prevents complications such as stiffness and instabilities.

Rehabilitation and Recovery

First six weeks (early postoperative phase).

• It is important to manage pain, protect the incision, as well as minimize swelling.
• During this phase, a sling will be used to provide comfort and support.
• Exercises that are commonly used include light isometric exercises and gentle pendulum movements, which can be facilitated by physical therapists.

Six to Twelve Weeks (Intermediate Postoperative Phase)

• It is important to gradually increase the range and strength of motion.
• In this phase, you will begin active-assisted range of motion exercises to help your therapist move your shoulder.
• In addition, we will incorporate introductory strengthening exercise targeting the rotatorcuff muscles and the scapular.

Twelve to twenty-four stages (Last postoperative phase)

• The emphasis is on improving strength through exercise, refining the proprioception of the body, and engaging with functional activities.
• As you advance, you will perform more difficult strengthening exercises and proprioception training to enhance your shoulder's balance and coordination. In addition, you'll begin working on functional tasks, such as reaching, dressing, and lifting.

Return to Activity: Four to Eight Months and Beyond

• Focus is placed on re-integrating gradually your favorite activities.
• After receiving the approval of your doctor and physical therapy, you can slowly resume most activities including sports and hobbies. You should listen to your body, and avoid any strenuous exercises that can cause pain or injury.

Risks and Complications

• Infection

There is still a chance that you could contract a disease after surgery, despite all precautions. This can be manifested as localized inflammation, fever, or warmth. In severe cases of infection, surgical intervention is often required.

• Implant Loosening

As the prosthesis ages, it may lose its stability, cause pain and reduce function. Implant failure may require revision surgery.

• Instability

The reverse shoulder prothesis changes the biomechanics, and can increase the chances of instability or dislocation. This risk can be minimized by avoiding certain movements and activities.

• Nerve Injury

The nerves around the shoulder can be damaged during surgery. This may cause temporary or long-term weakness, numbness or tingling of the hand or arm. The symptoms of nerve damage can be treated with physical therapy or rehabilitation.

• Fracture

The humerus, or scapula, can be fractured during surgery or from complications. A second surgery may be required to stabilize the shoulder and repair the fracture.

• The Range of Motion is Limited

Even though they may have improved in terms of pain and function after surgery, some patients will still have a limited range in their shoulder. In order to maximize shoulder functionality and mobility, rehabilitation efforts are made.

• Rotator Cuff Dysfunction

Even though a reverse shoulder implant does not require a functional rotator, a deltoid weakness or dysfunction can still affect the shoulder's stability and functionality.

• Blood Clots

Following surgery, there's a risk that blood clots will form in the legs (deep veins thrombosis). This could lead to complications more serious such as pulmonary embolism. This risk can be reduced by prescribing blood-thinning drugs and compression socks.

• Allergic Reaction

Rarely patients can experience an allergic response to the materials in the shoulder prosthesis. This may cause localized swelling or hypersensitivity.

• Additional General Risks

Other risks include bleeding, complications with anesthesia, problems with wound healing, and adverse drug reactions.

Cost of reverse shoulder replacement surgery in Chennai

The cost of shoulder surgery can vary from about Rs3,00,000. to Rs6,00,000.

Best Surgeons for Reverse Shoulder Arthroplasty / Replacement in Chennai

Shriram Krishnamoorthy of Shri Bone & Joint Clinic in Chennai is the most qualified surgeon for Reverse shoulder replacement. He has over 10 years of experience working in the field of orthopedics. He is an orthopedic surgeon who has been certified by the National Board.

His area of interest includes knee and shoulder replacement, knee andshoulder arthroscopy. cartilage repair and preservation, ortho biologics. and geriatric orthopedistry. He has participated in 1000 knee surgeries at Fortis Malar Hospital.

Best Hospitals for Reverse Shoulder Replacement/Arthroplasty in Chennai

Shri Bone & Joint Clinic offers the best Reverse Shoulder Reconstruction in Chennai. Two branches are available in Chennai. The first is located in Adyar while the second one is located in Aminjikarai. You can reach us any time, we're available 24 hours per day.

Our team can help you with immediate relief from knee-related issues. We offer affordable medical treatment for all knee-related issues.

Appointments are made on the same date, pending the availability of the doctor. Patients who walk in with an emergency are given equal priority.