HYDERABAD:Reverse shoulder replacement surgery is gaining popularity as a safe and effective option for those suffering from rotator cuff muscle tears. Rotator cuffs are an important part of the shoulder and play a pivotal role in ensuring free shoulder movements. Therefore, any damage or injury to the rotator cuff debilitates shoulder movement.
If rotator cuff tears are neglected, the problem gets aggravated and the person cannot even lift the shoulder, explains Dr B Chakradhar Reddy, consultant orthopaedic surgeon at the Global Hospitals. Rotator cuff tear problem forms a major percentage of shoulder-related problems. With no proper treatment available, earlier patients were left to suffer. But with the advent of reverse shoulder replacement surgery, technically described as Trabecular Metal Reverse Shoulder Replacement, patients suffering for a long time can heave a sigh of relief.
“Recently, we performed reverse shoulder surgery for a person who was diagnosed with a rotator cuff muscle tear about 10 years ago. It was not repaired at that time. Had it been repaired then with a relatively minor surgery, the shoulder function could have been restored. The patient may not have required extensive surgery at a later date.
If rotator cuff tears are diagnosed early and treated, long-term problems such as rotator cuff related arthritis can be avoided,” says Dr DN Reddy, senior consultant orthopaedic surgeon, at Continental Hospitals. Orthopaedic surgeons hope reverse shoulder replacement surgery or reverse shoulder arthroplasty can give a new lease of life to rotator cuff tear patients and improve their quality of life. But how is it performed? What mechanism goes into treating the problem undressed for years?
As the name suggests, in reverse replacement surgery, shoulder joint mechanism geometry is revised. The normal shoulder joint has a large ball on a small socket, with the ball on the top end of the arm bone (Humerus).
The socket is on the shoulder blade (scapula). Muscles and ligaments hold this ball on to the cup. When the arm is raised, the ball is not centered in patients with a tear in cuff muscles. Abnormal loading occurs in the shoulder, which causes arthritis. For this type of arthritis (cuff arthropathy) a reverse shoulder replacement is indicated. “Thus in this procedure, the ball is placed on the socket side (scapula) and the socket side is placed on the Humerus (arm bone) reversing the normal geometry of the joint. The intact outer muscles on the arm (Deltoid muscles) help in lifting the arm without the need of inner rotator cuff muscles,” said Dr Chakradhar.
While the surgery is termed a great reliever, orthropaedic surgeons caution that it has to be referred to patients with the right conditions. Reverse Shoulder Replacement Surgery is performed on people with painful arthritis with extensive damage to the rotator cuff muscles. Normally, it is advised to patients who suffer from rotator cuff tears due to trauma induced injury, said Dr DN Reddy.