Joint replacement · shoulder
Reverse shoulder replacement
Reverses the geometry of the joint so that the deltoid can help lift the arm when the rotator cuff can no longer provide adequate function.
General guidance
When it may be considered
- rotator cuff tear arthropathy
- selected complex fractures
- selected revision procedures and fracture sequelae
Individual decision
How suitability is determined
Assessment covers deltoid function, bone loss, deformity, range of motion and the risk of instability.
An abnormal scan alone is not an indication for surgery. The symptoms, clinical examination, progression and the patient's goals must be considered together.
Surgical plan
Decisions that tailor the procedure
- deltoid function and neurological status
- bone loss and positioning of the glenoid component
- reconstruction tension and the risk of instability
- associated fractures, tendon repairs or revision procedures
Alternatives
What is discussed before surgery
For rotator cuff tears, the options considered include rehabilitation, a selected injection, whether the tendon can be repaired and other reconstructive procedures. Reverse shoulder replacement is reserved for cuff tear arthropathy, symptomatic irreparable tears and suitable fracture or revision cases.
Before the procedure
Preparation and safety
- bring all investigation results, previous operative records and a complete list of medication;
- tell the medical team about diabetes, anticoagulant treatment, allergies, smoking and any active infection;
- do not stop or change long-term medication without instructions from the medical team;
- plan transport, help at home and any recommended assistive devices.
After the procedure
Rehabilitation
Movement and strength are regained progressively while protecting the reconstruction and following each stage of rehabilitation.
The exact protocol, permitted weight-bearing and follow-up schedule depend on the procedure performed and individual progress.
Informed consent
Risks and limitations
Risks include instability, infection, fracture, wear, nerve injury and the need for revision surgery.
No procedure can guarantee complete pain relief or a return to a particular level of activity.
After surgery
Signs that require prompt medical assessment
- fever, discharge, spreading redness or worsening pain at the wound;
- sudden swelling of the calf, chest pain or difficulty breathing;
- uncontrolled pain, new numbness, or a change in the colour or temperature of the limb.
For severe symptoms or an emergency, call 112. The instructions given to you at discharge take priority over the general information on this page.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical sources used for patient information
First step
Consultation, diagnosis and an individual treatment recommendation
This information does not replace a consultation. Surgery is recommended only after the individual benefits, alternatives and risks have been assessed.