Shoulder Arthritis: Reverse Total Shoulder Replacement Animation

Shoulder Arthritis: Reverse Total Shoulder Replacement Animation

This video demonstrates the steps for a reverse shoulder replacement of a right shoulder. After the surgical approach is completed, the surgeon will position instruments to help guide the removal of the arthritic humeral head or ball of the shoulder. Once the instruments are placed, the ball is removed with a saw.

A protective cap is then placed on the cut bone, and attention is turned to preparing the glenoid socket. All remaining cartilage is removed from the surface of the socket and a pin guide is positioned. A pin is introduced into the central hollow portion of the guide. This pin remains and the guide is then removed.

Several instruments are introduced over this pin to perform steps that prepare the bone for the final implant, including sizing and soft tissue removal. Once the bone is prepared, the first portion of the implant, called a baseplate, is secured into the prepared surface. Smaller screws are placed along the periphery of the baseplate to provide additional fixation.

Next, the appropriately sized metal ball called a glenosphere, is introduced and seated on top of the baseplate and impacted into position. A final screw is placed into the center of the glenosphere, confirming it is in the appropriate place. Now that the socket side is complete, the surgeon will go back to the upper arm to finish the surgery.

The protector cap is removed from the cut surface, and a series of instruments are introduced into the upper arm to prepare the bone for a metal stem. Once the correct size metal stem is determined, the rest of the bone is prepared to accept the appropriately sized cup portion of the implant. With all sizes determined, the surgeon is ready to place final implants.

The metal stem is impacted into bone and the plastic liner acting as the new cartilage is secured into the cup portion of the stem. The joint can now be reduced into place, and the surgeon takes the shoulder through different motions to check for stability of the joint.