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Last Updated: Jan 10, 2023

Revision Replacement - What Should You Know?

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Dr. Sunil Kumar DashOrthopedic Doctor • 25 Years Exp.MBBS, MS - Orthopedics, Fellowship, Depuy Joint Replacement
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The shoulder is a complex joint consisting of a number of bones, ball, socket, and cartilage. For people suffering from arthritis of the shoulder joint, a total replacement of the shoulder joint is often a successful procedure. It significantly improves pain and range of motion. However, in case the patient is suffering from a special type of arthritis of the joint known as “cuff tear arthropathy”, a total shoulder replacement often does not produce the desired result. These people suffer from large rotator cuff tear as well as arthritis. For such patients, a reverse shoulder arthroplasty often show better results.

Reverse Shoulder Arthroplasty

In traditional total shoulder replacement, the device put into the joint consists of a plastic cup fitted into the glenoid bone, also known as the socket, and a metal ball attached to the top of the humerus, the upper arm bone. In a way, it mimics the configuration of the original shoulder joint. However, in case of reverse shoulder arthroplasty, the positions of the metal ball and the socket are interchanged. The plastic cup is attached to the humeral head whereas the metal ball is attached to the glenoid bone.

Benefits of the Procedure

A reverse shoulder arthroplasty works better for patients who have a large rotator cuff tear along with arthritis. There are a number of rotator cuff muscles in the shoulder and they help to hold the arm in position as well as provide power to the arm during extreme movements. In case of people with large rotator cuff tear and arthropathy, the upper arm has to rely on different muscles for movement because the rotator cuff muscles don’t function. Hence, the arm has to depend on other muscles such as the deltoid muscles, to position and power the arm. This is why a reverse arthroplasty is carried out.

Who Can Undergo This Surgery?

Every patient with cuff tear arthropathy is not a candidate for reverse shoulder arthroplasty. Surgeons recommend this surgery when the patient is suffering from:

● A total tear of the rotator cuff which cannot be repaired

● A special type of shoulder arthritis known as cuff tear arthropathy

● An unsuccessful shoulder replacement surgery

● Extreme shoulder pain along with difficulty in lifting the arm over the head or away from the body

● A complex type of fracture in shoulder joint

● A chronic dislocation of the shoulder

● A tumor in shoulder joint

Doctors can also suggest this procedure if the patient had previously tried other remedial measures such as medications, rest, physical therapy, injections, etc., but was not successful in alleviating the pain and improving the range of motion of the shoulder.


There are some medications that you need to stop before the surgery since they may cause excessive bleeding after the surgery. Some of these medicines are blood-thinning medicines and Non-steroidal anti-inflammatory medicines.