A reverse shoulder replacement swaps the ball and socket of your shoulder around, so the big deltoid muscle can lift your arm WITHOUT a working rotator cuff.
It’s the main operation for shoulders where the cuff is torn beyond repair and the joint has become arthritic. Most people get much better lifting and much less pain. Turning the arm outward usually improves only a little.
In modern studies, about 1 in 10 people have a complication, and about 1 in 40 need a redo within the first years. People under 60 do less well.
Why a “reverse” and not a normal replacement
- A normal shoulder replacement still needs the rotator cuff to steady and power the joint
- If the cuff is gone, a normal replacement has nothing to work with
- A reverse replacement puts the ball on the shoulder blade and the socket on the arm. That changes the leverage so the deltoid can lift the arm on its own
What you can expect to get back
- Lifting the arm: usually a big gain. In one long-term review, people gained about 50 degrees of lifting forward and out to the side
- Pain: usually much better
- Turning the arm outward: only a small gain on average. Reaching behind your head, washing your hair or reaching across may stay awkward. Ask about this before surgery
- Reaching behind your back: often limited
The lift comes back. The outward turn mostly doesn’t. Know that going in.
The risks, honestly
- Modern results: about 1 in 10 have a complication, and about 1 in 40 need a redo operation
- Older, long-term studies of earlier implants show much higher numbers. Newer implants seem safer, but their very long-term results aren’t in yet
- The main problems: dislocation (the joint popping out), infection, and wear or loosening of the parts
- Under 60: more dislocations and more redo surgery than in older people, probably because younger people ask more of the joint
Recovery, roughly
- Weeks 0 to 4 or 6: sling most of the time. Gentle movement as your surgeon allows. Elbow, wrist and hand moving from day one
- Weeks 6 to 12: sling off, lifting the arm yourself, light daily tasks
- Months 3 to 6: strengthening the deltoid and shoulder blade muscles
- Up to a year: continued gains in strength and comfort
Your surgeon’s own protocol comes first. Implant designs and approaches vary.
Protecting the new joint early on
- The risky position for dislocation is the hand reaching behind your back with the arm pulled back, like tucking in a shirt or pushing up from a chair behind you
- Don’t push yourself up out of a chair or bed with the operated arm in the early weeks
- Follow your surgeon’s rules on lifting and positions. They’re specific to your implant
Is it right for you?
- Usually yes if: you can’t lift the arm much, the cuff can’t be repaired, the joint is arthritic, and pain is limiting your life
- Maybe try first: a deltoid strengthening program, if you can still lift above about 50 degrees. See rotator cuff tear arthropathy
- Think hard if: you’re under 60 or very active, because the joint has more to cope with and results are less reliable
Questions to ask your surgeon
- What movement can I realistically expect back, especially turning the arm outward?
- What are your own complication and redo rates?
- Which positions should I avoid, and for how long?
- What happens if it dislocates or gets infected?
Call your surgeon today if
- The shoulder suddenly pops, clunks, looks out of shape or you can’t use it. It may have dislocated
- It becomes hot, red, swollen or increasingly painful, or you feel unwell or feverish
- The wound weeps or leaks
- You have new numbness or weakness in the arm or hand
Lift and pain relief are the win. Outward turning is the trade-off. Under 60 is the caution.