At Lakeland Hospital, Niles, orthopedic surgeon James Grannell, DO, is
performing reverse shoulder replacement surgery. This procedure involves a
prosthesis design that "reverses" the mechanical structure of the shoulder. The
prosthesis changes the orientation of the shoulder, replacing the glenoid with
an artificial ball and the humeral head with a humeral socket.
"A reverse shoulder
replacement changes the mechanics of the shoulder, enabling the joint to
function even in the absence of a rotator cuff," stated Dr. Grannell. "Prior to
the introduction of this new type of artificial joint, patients who suffered
from rotator-cuff arthropathy and arthritis were not especially good candidates
for joint replacement. Now, we can significantly decrease pain and improve
mobility in these patients."
This procedure is an
appropriate choice for patients who would otherwise have no good options for
surgical repair. Candidates for reverse shoulder joint replacement are
• A rotator cuff-deficient shoulder joint with
• Failed joint replacement with a rotator
• Evidence of upward displacement of the
humeral head with respect to the glenoid
• Complex shoulder fracture
This procedure is not
recommended for younger patients, patients with infections or deficiencies in
the scapula; or for patients without functioning deltoid muscles.
An individual with a
rotator cuff-deficient shoulder and glenohumeral arthritis often shows evidence
of upward displacement of the humeral head. Conventional surgical methods, such
as hemiarthroplasty, bipolar, and total-shoulder arthroplasty, often do not
provide a significant improvement in pain or mobility. Reversing the mechanics
of the joint in this manner neutralizes the vertical forces of the deltoid
muscle and maintains joint stability.
the condition of the deltoid muscle, a patient who receives a reverse shoulder
joint replacement can progress from severe shoulder dysfunction to an elevation
of 90 degrees or more. Following surgery and the prescribed physical therapy,
the patient finds that daily tasks, such as eating, drinking, combing hair and
dressing, are no longer difficult activities.
a drastic difference in their range of mobility and their ability to perform
daily activities with this type of joint replacement," continued Dr. Grannell.
"The prosthesis and follow-up physical therapy restore mobility and provide
significant pain relief."
For more information, a
consult, or to refer a patient, call Niles Orthopedics at 269-684-3028.