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'Reverse' Shoulder Replacement Surgery Helps Patients with Arthritis and Rotator Cuff Tears

Armen Hareyan's picture

Shoulder Pain

FDA-approved procedure eliminates pain and vastly improves range of motion

The constant pain in Helen Richardson's right shoulder from arthritis and damaged tendons forced her to give up many of the activities she loved. "I could hang my arm out to the side, but I couldn't raise it and had very limited forward motion. I love to swim, but I couldn't do the backstroke any more. I couldn't play golf any more. I couldn't even hang my clothes on the line to dry," recalls Mrs. Richardson, 86, of Rosemont, Md.

But thanks to a new type of shoulder replacement surgery offered by the University of Maryland Department of Orthopaedics, Mrs. Richardson is able to do many of the things that were once out of her reach. "There's no more pain. I have a lot more freedom. This operation has really given me my life back," she says. Mrs. Richardson, who also has had several knee replacement surgeries, teaches deepwater exercise three times a week, swims, plays golf with her husband and gives piano lessons.

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Anand M. Murthi, M.D., an orthopaedic surgeon at the University of Maryland Medical Center, specializing in shoulder and elbow injuries, and an assistant professor of orthopaedics at the University of Maryland School of Medicine, rebuilt Mrs. Richardson's shoulder joint through a procedure called a "reverse" shoulder replacement.

"Patients often see a drastic difference in their range of motion and ability to perform daily activities such as eating or combing their hair. It's a miraculous change of lifestyle," says Dr. Murthi, who has performed 20 of these surgeries since the U.S. Food and Drug Administration approved the operation last year. "We finally have a way to help patients with arthritis and serious rotator cuff tears who are often not good candidates for standard shoulder replacement surgery."

The shoulder is a ball-and-socket joint, with the top of the arm bone, or humerus, shaped like a ball that fits into a socket in the shoulder blade, or scapula. The rotator cuff is made up of four muscles and tendons that help to lift and rotate the arm. Injury to the muscles and tendons can create severe arthritis within the joint, causing the bones to rub together.

In standard replacement surgery, the ball on the humerus is removed and replaced with a metal implant that fits into a new plastic socket in the scapula. In the reverse shoulder replacement, the surgeon rebuilds the joint with the ball and socket reversed