Reverse Shoulder Replacement

When the rotator cuff is torn beyond repair, a reverse shoulder replacement lets the shoulder lift again without it. Fellowship-trained care in Port St. Lucie and Palm Beach Gardens.

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What is a reverse shoulder replacement?

In a normal shoulder, the ball at the top of the arm bone sits in a shallow socket, and the rotator cuff keeps it centered while the arm moves. A standard total shoulder replacement copies that arrangement, so it depends on a rotator cuff that still works.

A reverse replacement swaps the parts. The ball is fixed to the socket side, and a cup goes on top of the arm bone. That changes the mechanics so the deltoid, the large muscle over the outside of the shoulder, can lift the arm without help from the rotator cuff.

Who is it for?

Rotator cuff tear arthropathy

Arthritis that develops after a large, long-standing rotator cuff tear lets the ball ride up out of position.

Rotator cuff tears that can no longer be repaired

A painful shoulder that cannot lift the arm, where the torn tendon has pulled back too far to reattach.

Arthritis with a damaged rotator cuff

A worn joint where the cuff is too weak or torn for a standard replacement to work well.

Pain and weakness that rehabilitation has not fixed

Night pain and an arm that will not lift, after therapy and other treatment have run their course.

Reverse or standard total shoulder?

The rotator cuff decides it. If the cuff is intact and working, a standard total shoulder replacement is usually the better choice. If the cuff is torn beyond repair or no longer working, a reverse replacement is designed for exactly that shoulder. An exam of strength in each direction, X-rays, and an MRI or CT scan show which one you have.

A replacement is not the first answer for a torn cuff. Many tears can be repaired or managed without surgery, and the rotator cuff tear treatment page covers those options.

Recovery

The arm is protected in a sling for the first weeks. Therapy then brings back movement first and strength after, over several months. Dr. Matarazzo will go through any long-term limits on lifting that apply to your shoulder before surgery, so you know what to expect.

What to expect

An exam that tests the rotator cuff in each direction
Imaging to see the joint and the state of the cuff
Repair or non-surgical care first, wherever it can still work
A plain answer on whether a reverse or standard replacement fits
A sling at first, then a staged rehabilitation plan
Follow-up at whichever office is closer to you

FAQ

Common Patient Questions

What is the difference between a reverse and a standard shoulder replacement?

A standard replacement copies the shoulder's normal ball-and-socket arrangement and relies on a working rotator cuff. A reverse replacement swaps the ball and socket so the deltoid muscle can lift the arm without the rotator cuff.

Who needs a reverse shoulder replacement?

Usually someone whose rotator cuff is torn beyond repair, often with arthritis that has followed the tear, and whose pain and weakness have not improved with other treatment.

How long is recovery after a reverse shoulder replacement?

The arm is in a sling for the first weeks, followed by several months of therapy to bring back movement and then strength.

Will I be able to lift my arm again?

Restoring the ability to raise the arm, which a torn rotator cuff often takes away, is the main aim. How far it comes back depends on the shoulder, and Dr. Matarazzo will set expectations with you before surgery.

Can my rotator cuff be repaired instead?

Often, yes, if the tear is still repairable. Replacement is for shoulders where repair is no longer possible or has not worked.

Will my insurance cover it?

Coverage depends on your plan. Once a treatment plan is set, our staff verify your benefits with your carrier and walk you through what is covered before you commit.

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