What is a Reverse Ball and Socket Arthroplasty?

A reverse ball and socket arthroplasty (shoulder replacement) is a surgical procedure in which parts of an arthritic joint are replaced with a prothesis or artificial parts. The normal shoulder is a ball and socket joint. The ball is called the humeral head and the socket is called the glenoid. The reverse ball and socket replacement changes the orientation of the shoulder so that the normal socket (glenoid) now is replaced with an artificial ball, and the normal ball (humeral head) is replaced with an implant that has a socket into which the artificial ball rests. This typically results in excellent pain relief and about a 75% of normal shoulder function.

How do you replace the shoulder?

The prosthesis will be placed through an incision down the front of the shoulder. The ball component is anchored in place with screws while the socket will be cemented in the humeral shaft.

Length of Stay

You will spend one to two nights in the hospital after this surgery. You will need to have someone to drive you home after you have been discharged.

Anesthesia

Patients usually have two types of anesthesia for this surgery. The first is general anesthesia, which means you are asleep. The second type of anesthesia is a nerve block. Your arm will be numb and will feel very strange. The nerve block will last about 12-14 hours. The anesthesiologist will speak to you on the day of surgery. The ultimate choice of anesthesia technique is up to you and your anesthesiologist.

Incision

You will have an incision down the front of your shoulder. After the incision has healed, it is usually very thin and not very noticeable.

Pain

While admitted to the hospital, you will have oral and IV pain medications prescribed for you. You will also have pain medication prescribed for when you are discharged home.

Sling

Your arm will be placed in a sling prior to leaving the operating room. When you go home you only need to wear the sling for protection, i.e. in a crowded area.

Dressings

You will go home with tape and gauze dressings. After 2 days you may remove the dressings. There may be steri strips or a glue like substance over the incisions. The steri strips are to remain in place until they fall off on their own. You may see clear suture material at the end of the incisions. The sutures will be removed at your first postoperative visit 10-14 days after your surgery.

Blood Thinners

After surgery blood thinners, in most cases, Aspirin, will be prescribed for two weeks. Please take one 325mg aspirin twice each day. This is to prevent blood clots. If you are considered high risk for developing a blood clot or have a history of blood clots, Coumadin or Warfarin may be prescribed About once a week blood will be drawn to make sure the correct dose is prescribed. A medical doctor will follow your lab values and notify you of the results and if your dose needs to be changed. DO NOT TAKE COUMADIN AND ASPIRIN.

Restrictions

Recovery from a reverse ball and socket shoulder replacement is three months. During that time you will have restrictions on the use of your operative arm. You may drive when you feel that you can properly control a car and you are NOT taking narcotic pain medication.

Day of surgery to Week 6: no opening or closing doors, no reaching behind your back, and no repetitive movements