A total shoulder prosthesis attempts to mimic the normal anatomy of the shoulder and has a plastic cup that attaches to the glenoid and a metal ball attached to the proximal end of the humerus. In the total inverted prosthesis, the component attached to the glenoid and the metal ball are inverted. The metal ball is fixed to the glenoid, and the plastic cup is fixed to the end of the humerus.
Reversed total shoulder prosthesis is indicated in large rotator cuff injuries, because it relies on the action of other muscles (the deltoid muscle) to move the arm. Compared to the reverse total shoulder prosthesis, the conventional shoulder prosthesis uses the rotator cuff to function properly.

WHAT ARE THE INDICATIONS FOR TOTAL REVERSE SHOULDER PROSTHESIS?

HOW TO PREPARE FOR SURGERY?

Medical Evaluation- Patients should have a complete physical examination, including an evaluation of their entire state of health.
Many patients with chronic conditions, such as heart disease, require a cardiologic consultation before surgery.
Medication
There are some medications that should be stopped before surgery, as they can cause excessive bleeding during surgery and therefore should be stopped 2 weeks before surgery:
– non-steroidal anti-inflammatory drugs – aspirin and ibuprofen.
If the patient is taking anticoagulant treatment, the discontinuation of this treatment should be discussed with the cardiologist before surgery.

HOW DOES THE SURGERY GO?

The surgical procedure of total reverse shoulder replacement lasts about 2 hours. The deltopectoral approach is used. The humeral head and the damaged glenoid surface are removed and the components of the prosthesis are positioned to restore shoulder function.

WHAT ARE THE COMPLICATIONS OF SURGERY?

Reversed total shoulder prosthesis is a high-precision surgical technique during which complications such as intraoperative bleeding, nerve damage and infection can occur.
Specific complications in the case of reverse total shoulder prosthesis include dislocation of the components, in these situations a revision of the shoulder prosthesis is necessary.

PAIN TREATMENT

After surgery, it is normal to feel pain, it is part of the healing process. The doctor recommends a series of anti-inflammatory drugs to reduce it.

HOW IS THE MEDICAL RECOVERY GOING?

After surgery the arm must be kept in a sling, after which medical recovery begins, initially with passive and then active movements. The patient will be able to eat and drink using the operated hand a few weeks after surgery.

WHAT TO DO AND WHAT NOT TO DO AFTER SURGERY?

A medical recovery program MUST be followed;
Extreme arm positions MUST be avoided in the first 6 weeks;
NO lifting weights heavier than 5 kg in the first 6 weeks;
NO leaning on the operated hand when lifting from the chair in the first 6 weeks.