Is a reverse shoulder replacement better than a regular one?

There are two main types of shoulder replacements. The anatomic shoulder replacment and the reverse shoulder replacement. These two forms of shoulder replacement are used for different clinical problems and patients. The anatomic shoulder replacement is used for shoulder arthritis in the setting of a normal rotator cuff, while the reverse shoulder replacment is used for other situations such as arthritis and a rotator cuff tear or massive rotator cuff tears that cannot be repaired. 

Recently, I have had some patients request a reverse replacement because they heard that the reverse replacement worked bettter than the traditional anatomic replacement. 

However, this is not true. An anatomic replacement tends to give a slightly better result than a reverse. I recently reviewed the outcomes data from my last 170 shoulder replacements to compare the anatomic and reverse replacement patients. Attached is a graph of the outcome scores showing that the anatomic replacement had slightly better scores on their SST and ASES scores. 

So, the bottom line is that both anatomic and reverse replacements work well. However, if a patient is a candidate for an anatomic replacement that is a better option. For this reason, I only reccomend reverse shoulder arthroplasty in situations where an anatomic replacement is not possible. 

Author

Brad Carofino, MD Dr. Brad Carofino is a board-certified (American Board of Orthopaedic Surgery), fellowship-trained orthopaedic surgeon who specializes in shoulder & upper extremity surgery. Dr. Carofino is an expert in shoulder replacement surgery, minimally invasive arthroscopic rotator cuff repair, and complex reconstructive procedures of the upper extremity.