The question arose...who is a candidate for reverse Total Shoulder Arthroplasty surgery?
First, the patient should be someone who is pretty much at the end of their rope. I just mean the surgery should not be considered until more conservative treatment has been exhausted. Physical therapy, analgesics and tincture of time should be tried without relief. Persistent and severe disability should be making an extreme impact on the person's lifestyle. The good patient is one in general good health, physically active and knowledgable as to the recovery time involved and have appropriate expectations.
Reverse TSA surgery is indicated when the patient's rotator cuff is fully torn or non functional. An experienced orthopedic surgeon will order x-Rays, cat scans and or MRIs to make the right recommendation for surgery. Surgical experience is a big factor in achieving a good result. Also the patient needs to commit to post operative therapy and physical limitations for quite a while. A sling is worn post op for a good six weeks, day and night. No driving during that time. Very minimal physical activity for six weeks. Long term commitment to gentle use of the operated shoulder is important.
While the age for undergoing this surgery is going down (it used to be performed only on people 70 or older), this is still a surgery for older people. Why? Working people who perform physically demanding jobs like construction are not good candidates. Heavy work puts too much demand on the replaced joint. Also, contact sports and athletic activity where one might fall are contraindicated. Demanding or risky activity is thought to shorten the life of the new joint and hastens the time when a second surgery might be required. Patients must be willing and able to cooperate in their care.
Only the patient can assess their individual disability. Only the surgeon can know his experience and training. When the patient and the surgeon have a meeting of the minds it may be time rTSA.
First, the patient should be someone who is pretty much at the end of their rope. I just mean the surgery should not be considered until more conservative treatment has been exhausted. Physical therapy, analgesics and tincture of time should be tried without relief. Persistent and severe disability should be making an extreme impact on the person's lifestyle. The good patient is one in general good health, physically active and knowledgable as to the recovery time involved and have appropriate expectations.
Reverse TSA surgery is indicated when the patient's rotator cuff is fully torn or non functional. An experienced orthopedic surgeon will order x-Rays, cat scans and or MRIs to make the right recommendation for surgery. Surgical experience is a big factor in achieving a good result. Also the patient needs to commit to post operative therapy and physical limitations for quite a while. A sling is worn post op for a good six weeks, day and night. No driving during that time. Very minimal physical activity for six weeks. Long term commitment to gentle use of the operated shoulder is important.
While the age for undergoing this surgery is going down (it used to be performed only on people 70 or older), this is still a surgery for older people. Why? Working people who perform physically demanding jobs like construction are not good candidates. Heavy work puts too much demand on the replaced joint. Also, contact sports and athletic activity where one might fall are contraindicated. Demanding or risky activity is thought to shorten the life of the new joint and hastens the time when a second surgery might be required. Patients must be willing and able to cooperate in their care.
Only the patient can assess their individual disability. Only the surgeon can know his experience and training. When the patient and the surgeon have a meeting of the minds it may be time rTSA.
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