Atlanta Bone and Joint Specialists
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    • Maurice Jové, M.D.
    • Nathan Jové, M.D.
    • Jeff Traub, M.D.
    • Brian Vanderhoof, D.O.
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      • Omid Midanaky, PA-C
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        • Arthritis 101
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      • Shoulder >
        • Total Shoulder Replacement
        • Reverse Total Shoulder Replacement
      • Outpatient Joint Replacement Center
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        • Rotator Cuff Tears
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        • Meniscus Tears
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      • Foot and Ankle >
        • Ankle Sprains and Instability
        • Achilles Tendon Tears
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    • Regenerative Medicine >
      • Stem Cell Therapy
      • Cartilage Restoration
      • PRP (Platelet-Rich Plasma) Injections
      • Hyaluronic Gel Injections
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    • Hand Surgery >
      • Carpal Tunnel Sydnrome
      • Cubittal Tunnel Syndrome
      • Trigger Finger
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      • Distal Radius Fracture
      • Ankle Fractures
    • Blood Clots After Orthopedic Surgery
    • Learning Center
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    • Video
    • Orthopedic Survey Center >
      • Outpatient Total Joint Replacement Survey
      • Painful Knee Replacement Survey
      • Painful Hip Replacement Survey
      • Rotator Cuff Surgery Survey
      • Meniscus Tear Survey
      • Partial Knee Replacement Survey
    • FAQ
    • How to Prepare and What to Expect Knee Surgery
    • Blog
  • Español
  • Online Scheduling
  • Home
  • Our Doctors
    • Maurice Jové, M.D.
    • Nathan Jové, M.D.
    • Jeff Traub, M.D.
    • Brian Vanderhoof, D.O.
    • Physician Assistants >
      • Omid Midanaky, PA-C
      • Aidan O'Connor, MPH, PA-C
      • Elissa Ricker, PA-C
  • Locations
  • Appointments
    • Online Scheduling
    • Forms
    • Referrals
    • Independent Medical Examination
    • Telemedince and E-Visits >
      • E-Visit Scheduler
    • Saturday Clinic
    • What To Expect
    • Medical Tourism
  • Our Office
    • About Us
    • Social Media >
      • Facebook
      • Instagram
      • LinkedIN
      • Twitter
      • YouTube
    • Orthopedic Expert Witness
    • Conditions Treated
    • Payments
    • Bracing
    • Office Staff >
      • Office Manager >
        • Brian Pallone
      • Front Desk & Checkout >
        • Decatur
        • Loganville >
          • Meagan
        • Snellville >
          • Cheryl
      • Billing & Collections >
        • Maurice Jové, M.D. >
          • Buffie
        • Nathan Jové, M.D. >
          • Mayra
          • Makenzie
        • Jeff Traub, M.D. >
          • Jennifer
          • Liz
      • Scheduling >
        • Jeff Traub, M.D. >
          • Andrea
        • Maurice Jové, M.D. >
          • Rachael
        • Nathan Jové, M.D. >
          • Lindsay
        • Brian Vanderhoof, D.O. >
          • Megan
      • Radiology >
        • David
        • Rebecca
        • Carla
        • Oscar
      • Medical Records >
        • Team
    • Insurance
    • MRI
    • Medical Records >
      • Decatur
      • Loganville
      • Snellville
    • Prescription Refill Request >
      • Decatur
      • Loganville
    • Reviews
    • Affiliate Hospital Resources >
      • Emory Decatur Hospital
    • Marketing Internship
    • Job Opportunities
  • Patient Education
    • Coronavirus Update Page
    • What is an Orthopedic Doctor
    • Joint Replacement Center >
      • Arthritis Center >
        • Arthritis 101
      • Hip >
        • Anterior Hip Replacement
        • Total Hip Replacement
      • Knee >
        • Total Knee Replacement
        • Anterior Reference Knee Replacement
        • Knee Replacement Surgery Recovery
        • Partial Knee Replacement
        • Patellofemoral Replacement
        • Tourniquet-less Knee Replacement
      • Shoulder >
        • Total Shoulder Replacement
        • Reverse Total Shoulder Replacement
      • Outpatient Joint Replacement Center
      • Metal Sensitivity and Nickel Allergy
      • Revision Surgery >
        • Revision Knee Replacement
        • Revision Hip Replacement Surgery
        • Metal on Metal Hip Problems
      • Infections >
        • Hip and Knee Replacement Infections
    • Sports Medicine Program >
      • Arthroscopic Surgery
      • Shoulder >
        • Rotator Cuff Tears
        • SLAP Tears
        • Labral Tears
      • Knee >
        • Meniscus Tears
        • ACL Tears
        • Patella (Kneecap) Instability
        • Patella (Kneecap) Dislocation
      • Foot and Ankle >
        • Ankle Sprains and Instability
        • Achilles Tendon Tears
      • Concussions
    • Regenerative Medicine >
      • Stem Cell Therapy
      • Cartilage Restoration
      • PRP (Platelet-Rich Plasma) Injections
      • Hyaluronic Gel Injections
    • EMG
    • Hip Fracture Center
    • Hand Surgery >
      • Carpal Tunnel Sydnrome
      • Cubittal Tunnel Syndrome
      • Trigger Finger
    • Fracture (Broken Bone) Center >
      • Distal Radius Fracture
      • Ankle Fractures
    • Blood Clots After Orthopedic Surgery
    • Learning Center
    • Home Therapy
    • Video
    • Orthopedic Survey Center >
      • Outpatient Total Joint Replacement Survey
      • Painful Knee Replacement Survey
      • Painful Hip Replacement Survey
      • Rotator Cuff Surgery Survey
      • Meniscus Tear Survey
      • Partial Knee Replacement Survey
    • FAQ
    • How to Prepare and What to Expect Knee Surgery
    • Blog
  • Español
  • Online Scheduling

Reverse Total Shoulder Replacement

The most versatile shoulder procedure available
Picture
X-Ray showing a reverse total shoulder replacement.
Picture
X-Ray showing a reverse total shoulder replacement implant overlying a shoulder X-Ray

What is a reverse total shoulder?

Picture
Picture of a reverse total shoulder arthropalsty implant. Notice the ball is where the socket used to be and the socket is where the ball used to be.
A reverse total shoulder replacement is a procedure performed in which the surgeon changes the "ball" and "socket" and reverses them.  Although it sounds odd, the procedure is designed for patients who have severe arthritis in the setting of a chronic or irreparable rotator cuff tear. 
The implant is effectively a "backwards" shoulder replacement.  It has become a major staple in the treatment of shoulder arthritis over the last 15 years and will likely remain that way for the years to come.

Who can get a reverse total shoulder replacement?

Seems odd. Take a well designed ball and socket design and alter it.  Well, luckily, there is a pretty good explanation as to why we do this procedure.  With a massive rotator cuff tear, the arm is commonly unable to be abducted (lifted up from the side).  This is due to the fact that the rotator cuff muscles elevate the arm.  When the rotator cuff is torn, chronically, it becomes non functional.  The normal head of the humerus (shoulder ball) starts to "ride" upwards, making it lose its central position on the socket and migrate superiorly (upwards).  By doing this, the arm loses its normal leverage ability to lift and no longer functions properly.  Over a long time frame, this rotator cuff tear leads to a severe form of arthritis called rotator cuff arthropathy. 
Picture
Picture displaying rotator cuff arthropathy. Notice how the ball is sitting adjacent to the acromion and there is no space (white arrow). to allow mobility of the shoulder.

How do I know if I am a candidate?

Picture
Picture identifying patient selection criteria for a reverse total shoulder replacement.
There are many patients who are candidates for the reverse total shoulder replacement.  The ideal candidate is someone aged over 60 years old with a chronic, irreparable rotator cuff that has severe arthritis of the shoulder.  This ideal patient has been identified through significant amounts of research and is the most likely to have an excellent result from the surgery.
It is important to know that routine total shoulder replacement differs from reverse total shoulder in that patients with regular shoulder replacements must have rotator cuff function.
There are people who are not candidates for reverse shoulder replacement which include younger patients, patients with infections and people who have severe bone loss in which fixation of the implants is likely to fail.

What to expect after surgery.

Picture
Sample picture of a high end sling commonly used for first 6 weeks after shoulder replacement.
So you have decided to undergo a reverse total shoulder replacement.  Now it is time to recover.
While the reverse shoulder replacement provides very early pain relief, the post-operative time period is long and arduous.  Expectations must be managed especially in the early postoperative period. 
For the first 4-6 weeks after surgery, expect to be in a sling with limitations in mobility.  Although surgeon preference, most surgeons prefer to let the implant heal into place prior to placing patients into strenous therapy.
After your first 4-6 weeks in the sling, our doctors will remove the sling and allow you to start formal physical therapy.  The therapy process can last several months as you begin to recover and restore your mobility.

Why so much therapy?

Picture
A patient undergoing kinesotaping after reverse total shoulder replacement.
Physical therapy after shoulder replacements is very difficult, especially with reverse shoulder replacements.  Why so difficult?
In order to be a candidate for this procedure, you must understand that the muscles that were used your entire life to lift you arm don't work.  The procedure changes the muscles used to lift the arm and so you must retrain these muscles to lift your arm. 

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  • Prior blood clot or pulmonary embolus
    • the #1 predictor of having another clot
  • Factor 5 Leiden
  • Von Willdebrands disease
  • Venous Statsis
  • Extensive immobilization after surgery
  • Lower Extremity surgery
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Office Hours

Mon-Fri: 9AM-5PM  


Telephone

Decatur                             404.296.5005
Loganville                         770.564.3393
Snellville                           770.985.9330

High School Football Season Added Coverage Hours

Saturdays During High School Football Season
Injury Clinic is for INJURED PLAYERS ONLY.
Snellville
ONLY.
9AM-10AM