Reverse Shoulder Replacement

Reverse shoulder joint replacement is a procedure developed for those who have exhausted all other treatment options. When damage within the shoulder has reached advanced stages of shoulder weakness and pain, it may become necessary to make changes in the normal mechanics of the shoulder.

People who have severe muscle weakening and loss of function may need to have their shoulder realigned through the reverse shoulder replacement procedure. In a normal healthy shoulder, the upper arm bone (humerus) ends in a ball shape. This fits into a socket formed by the shoulder blade (scapula). Together this ball and socket form the shoulder. With the Reverse Shoulder Replacement, the anatomy, or structure, of the healthy shoulder is reversed. The implant is designed so that the ball portion is attached to the scapula and the socket is placed at the upper end of the humerus.

Following the procedure, the stronger muscles in other parts of the shoulder are allowed to do the work of the joint as normally as possible. Also, the new mechanics of the shoulder and use of stronger muscles will hold the parts of the implant together more tightly than the injured shoulder could, thus making the joint more stable and less likely to dislocate.

Shoulder Anatomy
 

Shoulder Resurfacing

Healthy Shoulder

 

Shoulder Resurfacing

Arthritic Shoulder

 
Delta® Xtend Reverse Shoulder System
 

Reverse Shoulder Replacement

The Delta XTEND Reverse Shoulder has been used for over 15 years in Europe and has been in use since 2004 in the U.S. where it has demonstrated restored motion, pain relief, and stability when implanted by trained surgeons in the appropriate patients.1 Reversing the anatomy of the shoulder and using the healthy deltoid muscle can help restore some shoulder function in patients with end-stage cuff tear arthropathy, or a joint replacement that has failed with a grossly deficient rotator cuff joint.

What is different about DePuy Delta XTEND Reverse Shoulder System from traditional shoulder replacement?
 

Reverse Shoulder Replacement

The DePuy Delta XTEND Reverse Shoulder System consists of 5 components that change the orientation of the shoulder so that the shoulder socket (glenoid) is replaced with an artificial ball, and the normal ball (humeral head) is replaced with an implant that combines a socket and stem into which the artificial ball rests. This design alters the normal mechanics of the shoulder and enables the implant to stabilize the joint and restore limited motion when the rotator cuff is damaged or significant bone loss has compromised it.

Who is a candidate for surgery with the Delta XTEND Reverse Shoulder?
 

The Delta XTEND System is designed for people who

  • Have “end-stage cuff tear arthropathy,” a medical condition in which the rotator cuff has weakened and can no longer hold the shoulder joint intact or allow it to function normally
  • Have weakness that could be caused by arthritis, or a previous shoulder injury, such as a shoulder fracture, rotator cuff tear, or previous surgical intervention

The Delta XTEND Reverse Shoulder is generally used in people who have significant pain and little or no movement in their shoulder. It is not recommended for people who have bone disease or deficiencies to the shoulder blade (scapula). A functional deltoid is necessary to use this implant. It is not recommended for patients who have expectations of returning to demanding physical activity.

You and your surgeon must weigh the risks of surgery against its possible benefits.2

Who should perform my shoulder replacement surgery?
 

Any surgical procedure involves a certain amount of risk and should be entered into accordingly; shoulder replacement surgery is no different. Physicians who treat end-stage cuff tear arthropathy with a reverse shoulder replacement must be experienced shoulder arthroplasty surgeons. See our guide to selecting an orthpaedic shoulder specialist. DePuy holds surgeons to a high level of care and requires surgeons to attend specialized training before implanting the DePuy Delta XTEND Reverse Shoulder.

Note

Only an orthopaedic surgeon trained in shoulder replacement can provide advice about whether shoulder replacement surgery is right for you. See your physician to learn more.

The performance of a joint replacement depends on age, weight, activity level and othere factors. There are potential risks and recovery takes time. People with current infections or conditions limiting rehabilitation should not have this surgery.

Adverse Events

The following are the most frequent adverse events after shoulder arthroplasty: change in position of the components, loosening of components, dislocation, infection, hematoma, pneumonia, and cardiovascular disorders.

References

1 Data on File at DePuy. http://www.myshoulderreplacement.com/DePuy/docs/Shoulder/Products/
Info/Delta_XTEND.html

2 McFarland EG. Shrug off shoulder surgery myth, Johns Hopkins study suggests. Available at: www.jhintl.net/news/default.aspx?id=3086. Accessed on Feb. 27, 2009.