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What is reverse shoulder replacement surgery and is it right for you?

By:

Korey Karnes Huyler for Greater Baltimore Medical Center

August 24, 2020
Dr. D. Allan Lanzo, an orthopaedic surgeon and head of sports medicine at Greater Baltimore Medical Center, is quickly becoming known around the halls of the hospital as the “reverse shoulder replacement” guy.

This nickname is not surprising at all, as he’s the only person in his practice who performs the increasingly popular surgery. Reverse shoulder replacement happens to be one of the fastest-growing orthopaedic surgery options within the sports medicine department at GBMC.

Though Dr. Lanzo says total knee replacement surgeries are still his most common procedure, reverse shoulder replacement is growing in popularity. Over the last few years, he has performed about 30 to 40 per year at GBMC.

“When surgeons first started performing this surgery, it had a very high complication rate,” Dr. Lanzo explained. “But some really smart people figured it out, and now we see extraordinarily high results.”

What is reverse shoulder replacement?

In a reverse shoulder replacement, the ball and socket parts of the shoulder joint switch sides — meaning their natural position is reversed. And while the recovery time for a standard shoulder replacement is typically four to six weeks with your arm in a sling, recovery from reverse shoulder replacement is much quicker.

“This surgery is a game-changer,” Dr. Lanzo explained. “With rotator cuff surgery, it’s six weeks in a sling with restrictions in place for many months while the tendon heals. Reverse shoulder replacement is open surgery, not through a scope [like rotator cuff surgery]. So even though we are replacing the whole shoulder, patients heal faster with the reverse option because we don’t have to wait for the tendons to heal. Because of the reversal of the geometry of this surgery, you get rid of the arthritis and we put the joint in a better position for the deltoid to work on its own. We no longer need the rotator cuff for the shoulder to function at a high level.”

But before you book this surgery, know that reverse total shoulder replacement is a complex procedure and best for patients with the following conditions:
  • Rotator cuff tear arthropathy (a severe and complex form of shoulder arthritis)
  • Large or massive tears (for people approximately 60 and older, typically chronic)
  • Shoulder fractures (usually from a fall or other accident)
Another thing Dr. Lanzo and his patients like about reverse shoulder replacement surgery is there are predictable results with faster recovery.

“The people who need reverse shoulder replacement are a small subset of patients who we know won’t be successful with traditional surgery,” he said. “But this surgery is so successful that people sometimes choose this over other available options like physical therapy, cortisone shots and other surgical procedures.”

“Of all my patients,” he added, “people who have a reverse shoulder replacement are the happiest, the quickest.”
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