Anatomic vs reverse total shoulder replacement

So what are the types of shoulder replacements? Well, the most common shoulder replacements are two broad categories. There's anatomic and there's reverse shoulder replacement. An anatomic replacement most commonly is total shoulder. We're working on both sides of the joint. As the name sounds, the goal there is to restore the anatomy of the shoulder. What I mean by that is removing the diseased cartilage by replacing the ball with a metal ball most commonly, and on the socket side, placing a high-strength plastic most commonly that restores a joint that limits pain or reduces it by eliminating in knee arthritis and then improves range of motion because there's improved gliding of the joint itself. In some scenarios under the anatomic category, there's what's called a hemiarthroplasty. Now the goal there is to simply replace the ball side and let the socket be alone. That is a consideration in people who have a socket that we are worried about placing a total shoulder replacement. In particular, that is a long-term sort of consideration. That's typically a consideration, somebody who's very young where we're worried about the impact of an implant for decades to come in the future. However, there are limitations with a partial replacement or a hemi shoulder arthroplasty, and that is simply the lack of pain improvement. You can get improvement in pain, but it is not as high as you get when you replace both sides of the joint. Additionally, with a hemi arthroplasty or partial shoulder replacement, you see that the recovery is much longer. So for instance, on average with a shoulder replacement, you're doing both sides of the joint, that's going to be on the order of several months. But with a hemiarthroplasty, it is many, many months. One study, for instance, showed that it was 18 months on average. So it's a consideration in some people, in particular cases, particularly the young heavy lifter, but it's much less common. Now, the second category of shoulder replacements, it's actually about 70% of the shoulder replacements done in the United States at this point in time, is reverse shoulder replacement. With a reverse shoulder replacement, we put a ball on the socket side and a similar cup on the arm bone side. The goal here is also to remove arthritis, but additionally, Additionally, it provides stability to the joint because normally the rotator cuff provides stability to the joint. However, there are some situations where the rotator cuff is compromised or the socket cannot accommodate a plastic socket. And in those cases, a reverse shoulder replacement restores stability and provides pain relief. And the reason it's become so common is there's many reasons to do that. Rotator cuff problems in association with arthritis, particularly where there's an irreparable rotator cuff tear. You'll see this in people who break their shoulder, reverse shoulder replacement for proximal humerus fracture. Called, or in some cases what's called primary arthritis with problems with the bone itself. And in those cases, reverse shoulder replacement is the most reliable solution.