Arthritis of the shoulder is much less common than arthritis of the knee or hip. When evaluating patients with shoulder arthritis the first consideration is the condition of the rotator cuff. This is a group of tendons that envelop the ball of the shoulder joint and is necessary for normal shoulder function. If there is evidence of a rotator cuff tear on physical exam or patients have had a previous rotator cuff repair, an MRI to fully evaluate the rotator cuff tendons is helpful. Depending on the integrity of the rotator cuff, one of two surgical options exist for treatment of shoulder arthritis.
Reverse shoulder arthroplasty is a challenging surgical procedure that is indicated in patients with shoulder arthritis and a concomitant large rotator cuff tear. Standard shoulder arthroplasty in these patients does not give good clinical results. The reverse shoulder arthroplasty involves placing the ball component on the glenoid (glenosphere) and the cup component on the humerus; this is opposite of the normal anatomy, hence the term “reverse shoulder”. The surgery is technically more difficult, but the in-hospital stay is roughly the same as for standard total shoulder replacement patients. Most patients have good relief of pain with this procedure, but the risk of complications is slightly higher and final functional outcome is not as good as a primary total shoulder arthroplasty.