Anatomic

Normal

Reverse

There are two main types of total shoulder replacement: anatomic total shoulder replacement and reverse total shoulder replacement.

They are used for two different shoulder conditions. However, both provide excellent pain relief, good function, and generally high satisfaction rates. The discussion below reviews anatomic and reverse total shoulder replacement.

Anatomic total shoulder replacement:

Anatomic total shoulder replacement was originally introduced in the United States in the 1970’s by Dr. Charles Neer. It has undergone many iterations and improvements over the past several decades to become a refined and successful procedure. Satisfaction rates are generally greater than 90% in appropriately selected patients.

Anatomic total shoulder replacement involves replacing the “ball” portion of the shoulder ball and socket joint with a new metal ball. It also uses a special plastic liner that is placed over the surface of the shoulder “socket.” This plastic liner serves as new replacement cartilage. Together, the new metal ball and plastic cartilage line form the new shoulder joint. A shoulder replacement functions similar to the way a knee or hip replacement works, in that all three joint replacements fully replace the arthritic and painful joint.

Anatomic total shoulder replacement is designed for patients with painful shoulder arthritis. Additionally, patients must have intact rotator cuff tendons in the shoulder and cannot have severe shoulder socket bone loss (due to wear).

Reverse Total Shoulder Replacement:

Reverse total shoulder replacement was first FDA approved in the USA in November of 2003. Due to its success since then, it has become the fastest growing form of joint replacement, currently growing faster than either hip or knee replacement.

Reverse shoulder replacement was originally designed for patients that have both painful shoulder arthritis and rotator cuff tears. However, given the success of the implant, use of the reverse shoulder replacement has been expanded to include many other conditions, including:

• Shoulder arthritis with severe bone loss

• Large/massive rotator cuff tears that are not fixable

• Shoulder fractures that are not fixable

• Tumors around the shoulder

• Re-do (revision) shoulder replacement

• Many other conditions.

Reverse shoulder replacement is a full shoulder replacement and involves “reversing” the configuration of the shoulder joint. With a reverse shoulder replacement, a metal ball is placed on the shoulder socket and a socket is placed on the top of the arm bone. This creates a constrained joint that tightly fits together and enables the large deltoid muscle to take over the function of the rotator cuff tendons.

Similarities Between Reverse and Anatomic Shoulder Replacement:

• Both anatomic and reverse total shoulder replacement are a full shoulder joint replacement.

• Both give good pain relief and both give good function.

• Both have high satisfaction rates in appropriately selected patients.

Differences Between Reverse and Anatomic Shoulder Replacement:

• Anatomic total shoulder replacement preserves the original anatomy or configuration of the shoulder and is considered a more natural joint.

• Anatomic total shoulder replacement gives slightly more motion than a reverse, though in some patients that difference may not be noticeable.

• Reverse shoulder replacement does not rely on the rotator cuff tendons, so if they were to tear later it would not cause an issue.