Reverse Shoulder Replacement

Home 9 Reverse Shoulder Replacement

What is a reverse shoulder replacement?

A reverse shoulder replacement is a surgical procedure where the ball and socket inside the shoulder joint are reversed. The replacement ball is placed within the shoulder blade (scapula), and the socket is attached to the upper arm bone (humerus).
This is the reverse of a traditional shoulder replacement, in which the ball and socket mimic their natural placement in the body.
Total stemmed reverse shoulder replacement surgeries account for 72.7% of all primary total shoulder replacements in Australia today.

Source:
Lay Summary: Hip, Knee and Shoulder Replacement Supplementary Report. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2024

Dr Philip Markham is a no-gap surgeon for joint replacement surgeries in Wollongong. No-gap surgery includes the cost of the surgeon, the cost of the anaesthetist, and physiotherapy at home for eligible privately insured patients. All no-gap surgeries are performed at Macquarie University Hospital in Sydney.

What is the difference between a shoulder replacement and a reverse shoulder replacement?

A reverse shoulder replacement involves reversing the placement of the prosthetics used in a traditional shoulder replacement.
In a traditional shoulder replacement surgery, the surgeon mimics the natural anatomy of the shoulder, placing the ball on the upper arm bone and the socket within the shoulder blade.
In a reverse shoulder replacement surgery, the placement of the prosthetics is reversed, with the ball placed on the shoulder blade and the socket on the upper arm bone.
“This reversal makes it easier for the deltoid muscle to compensate for a torn rotator cuff, leading to easier, pain-free movement,” says Dr Markham.

What conditions do reverse shoulder replacements treat?

Reverse shoulder replacements are usually performed to treat severe injuries involving the rotator cuff, though there are multiple conditions where a reverse shoulder replacement may be the best solution.

These conditions can include:

A complete tear of the rotator cuff that cannot be repaired with surgery
Cuff tear arthropathy (arthritis that has developed due to a massive, long-standing rotator cuff injury)
A tumour within the shoulder joint
Complex shoulder joint fracture
Chronic shoulder dislocation

Reverse shoulder replacements can also be performed if a traditional shoulder replacement was unsuccessful, or if shoulder pain persists even with non-surgical intervention.

Traditional shoulder replacement vs shoulder replacement – what’s the difference?

“Both surgeries are used to relieve shoulder pain, but only a reverse shoulder replacement is able to restore movement to individuals with severely torn rotator cuffs. Consult with your surgeon to find out what is right for you,” says Dr Markham.

What happens during a reverse shoulder replacement?

A reverse shoulder procedure is typically a 1.5–2 hour procedure performed under general anaesthetic, with a local anaesthetic also administered around the shoulder.
During the procedure, Dr Markham will make an incision in the shoulder, carefully moving aside surrounding muscles and tissues to expose the shoulder joint.
He will then remove the damaged socket (glenoid) and the humeral head (the damaged ball part of the joint) and insert the metal and prosthetic components.
In a reverse shoulder replacement, the metal ball is attached to the shoulder blade (scapula) in place of the glenoid, and a plastic socket is attached to the arm bone (humerus).
He will then stabilise and reposition the new components to improve functionality before closing the incision.

What are the risks associated with reverse shoulder replacement surgery?

With a complex procedure such as reverse shoulder replacement surgery, there is a possibility of complications. These can include:

Dislocation of the prosthetic shoulder joint
Infection
Excess blood loss
Nerve damage
Anaesthetic complications
Shoulder fracture
Blood vessel injuries

Less common risks include:

Blood clots in the legs
Heart attack
Stroke

“All surgeries carry associated risks. We will explain the risks relevant to your procedure and the steps we take to minimise them,” says Dr Markham.

What can I not do after a reverse shoulder replacement?

The placement of the prosthetic in a reverse shoulder replacement does not allow the patient to reach behind their upper back, limiting the ability to perform tasks such as fastening a bra.

Who is a suitable candidate for reverse shoulder replacement?

Patients most suitable for reverse shoulder replacement include:

Patients with severe arthritis
Patients with rotator cuff tears
Patients who have previously undergone shoulder surgery and found the results unsatisfactory

Disclaimer

This information is for educational purposes only. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

This page was reviewed by Dr Philip Markham, June 2026
AHPRA Registration No. MED0001196569
BMedSci, MBChB, MRCSEd, FRACS, FAOrthA

Adhering to post-operative instructions, attending your follow-up appointments and participating actively in rehabilitation treatment will help mitigate any potential side effects of shoulder surgery.

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