Reverse Total Shoulder Replacement (also called reverse total shoulder arthroplasty)

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What it is

A reverse total shoulder replacement switches the positions of the ball and socket: a metal ball is fixed to the socket side, and a plastic cup is placed on the arm bone. This design lets the large deltoid muscle raise the arm, so it works even when the rotator cuff is torn and cannot be repaired. It is used for rotator cuff arthropathy (arthritis together with a worn-out cuff), large irreparable cuff tears that cause weakness, some complex fractures, and failed prior shoulder replacements.

Common symptoms

• Shoulder pain with weakness lifting the arm — sometimes an inability to raise it at all
• Arthritis pain combined with a longstanding rotator cuff tear
• Loss of function that limits dressing, reaching, and daily tasks
• Pain and weakness that persist despite therapy and injections

Non-surgical options

• Physical therapy focused on the deltoid and the remaining muscles
• Anti-inflammatory medication when appropriate
• A corticosteroid injection into the joint
• Activity modification

The procedure

Performed at the hospital or surgery center under anesthesia, usually with a nerve block. Through an incision at the front of the shoulder, a baseplate and metal ball are secured to the socket and a stemmed plastic socket is placed on the humerus. Most patients stay one night, with the arm in a sling.

Recovery timeline

• Weeks 0–6Sling for protection. Gentle motion within set limits. Avoid reaching behind the back and bearing weight through the arm.
• Weeks 6–12Sling weaned. Active motion and light strengthening begin, guided by therapy.
• Months 3–6Strength and overhead reach keep improving. Return to daily activities and light recreation.
• Months 6–12Most patients gain reliable pain relief and the ability to raise the arm. Heavy lifting is usually limited long-term to protect the implant.

The information on this page is provided for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. Individual cases vary. Always consult a qualified clinician about your condition. In an emergency call 911.