Total Shoulder Replacement: Episode 71

• In this episode: We discuss total shoulder arthroplasty (TSA) both traditional and reverse.

• Chip Review: Wilde Brand – Chicken Chips, Chicken & Waffles – (07:58)

• Trivia question of the week: Which US state raises the most Turkeys? – (06:33)

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Brief overview of the episode:

            Total shoulder replacement (TSR) more formally known as total shoulder arthroplasty (TSA). This is a common procedure these days but it was rare until about 20 years ago. Back then you would see about 2 a year. Now we see 2 a week.

            There is a traditional approach. This is where the ball and socket stay on their anatomical side, the ball at the end of the humerus and the socket on the shoulder blade. With a reverse total shoulder arthroplasty (rTSA) these positions are switched. The ball is now on the shoulder blade and the socket is on the humerus.

            The reverse is more commonly used when there is instability in the shoulder, usually due to a rotator cuff tears. Perform a rTSA allows the patient much improved joint congruency versus the typical anatomical position. The down side of a rTSA is that typically your range of motion will be slightly less. Maybe as much as 20 degress. If for some reason you would need a revision surgery on either a reverse total shoulder you would only be able to have a rTSA again. There is unfortunately a change in bone structure that won’t allow a traditional to be performed at that point.

            The opposite is true with a traditional total shoulder replacement. If a revision is needed you can perform another traditional or a reverse. There is also more range of motion possible. However, the first few months of recovery are typical slower due to increased pain and weakness.

            Both surgeries do incredible well long term. This is really a great surgery. We have found that most people find the rehabilitation portion to go more smoothly than they would have expected with less pain and better functional outcomes.

 

Other episodes you might enjoy:

Biceps Tendonitis: Episode 24

Knee Replacement: Episode 58

Osteoarthritis & Rheumatoid Arthritis: Episode 57