Reverse Shoulder Replacement
What is reverse shoulder replacement?
Reverse shoulder arthroplasty (RSA) is similar to total shoulder replacement in that it replaces the ball and socket with implants. However, anatomic total shoulder replacement requires the patient have a well-functioning rotator cuff because the rotator cuff is vital to shoulder stability, rotation, and control.
When a patient does not have a functioning rotator cuff, has tried conservative therapy, and continues to suffer persistent disabling pain, stiffness, and disability, RSA is the surgical procedure of choice. RSA is the most significant advance in shoulder arthroplasty in the past 30 years. It has achieved outstanding popularity for patients with severe rotator cuff deficiency.
What are the indications for RSA?
RSA is for patients with:
- Osteoarthritis, rheumatoid arthritis, and arthritis associated with torn rotator cuff tendons, called rotator cuff arthropathy
- Massive irreparable rotator cuff tears
- Complex fractures of the head of the upper arm bone (proximal humerus fractures). Proximal humerus fractures are the third most common fracture in individuals over the age of 65; and are frequently the result of osteoporosis (brittle bone disease).
- When revision shoulder arthroplasty is indicated
Who is a good candidate for RSA?
Good candidates for RSA are individuals with severe pain and disability, and loss of normal shoulder mechanics who do not have a functioning rotator cuff. Most cannot raise their arm away from their body beyond 90°.
What is the difference between an anatomic and reverse shoulder replacement?
An anatomic shoulder replacement mimics normal shoulder anatomy. A plastic cup is fixed on the socket and the “metal ball” is attached to the upper arm bone. It relies on a competent rotator cuff to stabilize the joint and move the arm. In RSA the procedure is reversed from an anatomic shoulder replacement.
The reverse technique relies on an intact deltoid muscle when there is insufficient healthy tissue to stabilize the joint and move the arm. During RSA the “metal ball” is fixed to the old socket and a “plastic cup” on a stem is fixed to the upper arm bone to recreate the socket. RSA is a highly technical procedure that should only be performed by a shoulder expert like Dr. Frank Petrigliano.
The RSA procedure is effective providing excellent pain relief and restoring painless range of motion. Contact Dr. Petrigliano to schedule a consultation.
Why choose Dr. Petrigliano?
Dr. Frank Petrigliano is an orthopaedic surgeon who was fellowship trained in sports medicine and shoulder surgery at the prestigious Hospital for Special Surgery where he provided care to athletes of all ages. He currently serves as the head team physician for the LA Kings hockey team and associate team physician for USC Athletics. Dr. Petrigliano is a renowned orthopaedic surgeon and researcher who employs state of the art treatments and procedures to get you back to your active life and back to sport. He always treats his patients with compassion and respect. Dr. Petrigliano is located in El Segundo California, and serves greater Los Angeles, Beverly Hills, the South Bay, and the Santa Clarita Valley. Contact Dr. Petrigliano to schedule a consultation today.
At a Glance
Dr. Frank Petrigliano
- Associate Professor of Orthopaedic Surgery at USC
- Chief of the Epstein Family Center for Sports Medicine
- Team physician for the LA Kings and USC Athletics
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