Reverse Shoulder Replacement the plastic acting as rotator cuff

Posted by spiderbobr @spiderbobr, Dec 16, 2024

I'm out of surgery for the Full reverse shoulder replacement now for 6 months. I have noticed how much shorter my shoulder is on the surgical side as opposed to the good side as it is between 1 to 2 inches. shorter than the other side. So, why, and I'm sure there must be an answer, is the plastic disk that acts as the rotator cuff so thin, why could it not have been as thick as the cuff itself giving me at least within reasonable size as the original to make the look more realistic? It really shows and I have never seen or heard yet for an conjecture or other as to why this is.

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kobesnowy | @kobesnowy | Jul 22 9:25am

Same here
My operated shoulder is so much smaller and obvious too

Sue, Volunteer Mentor | @sueinmn | Jul 22 11:37am

In reply to @kobesnowy "Same here My operated shoulder is so much smaller and obvious too" + (show)

Here is a pictorial explanation that may help.
On the left is a natural humerus, see how the bone extends beyond the end of the shoulder?
At the center is a total replacement, where there is an intact rotator cuff to anchor and stabilize the implant. The implant mimics the natural arm - ball on the humerus, socket in the shoulder. It retains a more natural shape.
If there is no rotator cuff available, as in it is disintegrated or completely torn, the ball and socket would be unstable, resulting in dislocations. So someone figured out how to adapt the implant so that the deltoid muscle, across the back of the shoulder, can stabilize the implant. To do this, a modified ball is inserted into the shoulder socket, and a modified socket is created in the humerus.
The image on the right shows this. You can see it changes the position of the arm and shoulder substantially, with a more rounded form and less width. In addition, you probably will have less range of motion that with a full replacement.

Those changes on usage and appearance are what prompted me to try a rotator cuff repair instead (with the caveat that it might not work.) Nine months later, it is going okay and I am still being careful because the full healing and strengthening time is between one and two years for an extensive repair.

PS Connect reorganized the photos - left is full replacement, center is before, and right is reverse replacement

kobesnowy | @kobesnowy | Jul 22 12:23pm

In reply to @sueinmn "Here is a pictorial explanation that may help. On the left is a natural humerus, see..." + (show)

Thank you

From what I understand is there was a small tear but no cartilage and the ball was worn

I didn’t opt for either

It’s just so dam obvious

It’s thee days less than one month out

I’m so unhappy
But thank you for helping

Sue, Volunteer Mentor | @sueinmn | Jul 22 6:53pm

In reply to @kobesnowy "Thank you From what I understand is there was a small tear but no cartilage and..." + (show)

Please don't be unhappy yet! Your body is just barely beginning to heal, let alone rebuild your deltoid muscle to take over for the no-longer-used rotator cuff.
During PT you will have the opportunity to work on developing the deltoid, but don't rush things. Full recovery takes time and over time you should see improvement.
When you begin PT, be sure to let the therapist know you want to work on minimizing the difference in appearance of your shoulder so they can help design the right exercise program for you.

spiderbobr | @spiderbobr | Jul 23 12:39am

I originally wrote how my left shoulder (Reverse Replacement) is so much smaller. Well, it’s now going on 13 ½ months, and my shoulder is showing signs of once more gaining size. Yes, I’v been working hard on building the deltoid on that side. I’m not there yet, but gaining. I have actually hit a point where I’m happy with what I have, I’ll keep working on it, but it doesn’t bother me nearly as much as it used to. I have restrictions in use, I have also accepted those. No doubt in several years from now, I may be back, and maybe not as I now am almost 80. Life is what you make it.
Bob