Reverse Shoulder Arthroplasty
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What Is Reverse Shoulder Arthroplasty?
Reverse shoulder arthroplasty is a specialised technique for replacing the articular surfaces of the shoulder. In reverse shoulder arthroplasty, the humeral head and the concave component are positioned in the opposite orientation to normal anatomy.
This variation allows the shoulder joint to function normally in cases of rotator cuff tendon tears. Shoulder arthroplasty is usually performed to relieve pain and restore range of motion after conservative treatment has failed.
Conditions Treated with Reverse Shoulder Arthroplasty
The most common shoulder conditions treated with reverse shoulder arthroplasty are:
Osteoarthritis – destruction of the articular surfaces
Post-traumatic arthritis, meaning arthritis resulting from a shoulder injury
Rheumatoid arthritis and other inflammatory arthritides
Fractures in which the articular surface has been damaged
Massive irreparable shoulder tendon tears
Surgeon’s Experience in Reverse Shoulder Arthroplasty
Mr Leonidou specialised in shoulder arthroplasty at one of the largest centres in the world, the Reading Shoulder Unit. It was at this centre that the Copeland resurfacing arthroplasty and stemless reverse shoulder arthroplasty were developed. The doctor has extensive experience in shoulder arthroplasty, treating patients from around the world. In Greece, Mr Leonidou is applying reverse shoulder arthroplasty without a stem and without cement for the first time.
Preoperatively, the patient’s X-rays are entered into specialised software, which creates a three-dimensional digital model on the basis of which an individualised surgical plan is developed (digital templating).
Advantages of Stemless Reverse Shoulder Arthroplasty
Small incision – excellent cosmetic result
Personalised preoperative planning
Less damage to the underlying tissues
Bone preservation – only the worn surfaces are removed
Accurate placement of prosthetic components
Minimally invasive procedure
Bloodless surgery – no blood transfusion required
No immediate postoperative pain
Fewer intraoperative and postoperative complications
Shorter hospital stay – fast track protocol
Immediate shoulder mobilisation within a few days – rapid recovery protocol
What Materials Are Used?
The materials used are metallic (cobalt-chromium, titanium alloy) and polyethylene. Occasionally, ceramic materials may also be used.
Dr Leonidou uses the most modern and reliable materials, ensuring the best function and greater durability of the new joint.
Preparation Before Surgery
The patient will be informed about the proposed surgical treatment with reverse shoulder arthroplasty. The anaesthesiologist will examine the patient, take a detailed medical history, and organise the preoperative assessment.
The preoperative assessment includes routine blood tests, a chest X-ray, and a cardiological evaluation. The anaesthesiologist will provide the necessary instructions regarding the use or discontinuation of medications before surgery, as well as when the patient should begin fasting.
Hospital Admission and Anaesthesia
The patient is admitted to the hospital on the day of surgery. The specialised anaesthesiologist Dr Koutra administers regional anaesthesia, which ensures the absence of postoperative pain and allows immediate mobilisation of the patient.
When indicated, Dr Leonidou’s team applies, for the first time in Greece, shoulder arthroplasty without general anaesthesia. The patient receives only regional anaesthesia and remains awake throughout the surgery.
Duration of Surgery
The surgery lasts approximately 60–90 minutes.
How Large Is the Incision?
Dr Leonidou applies minimally invasive techniques for reverse shoulder arthroplasty. The incision is located on the outer surface of the shoulder and is less than 10 centimetres in length.
Postoperative Instructions
After surgery, the patient returns to the ward. Immediate mobilisation is encouraged. The patient does not have a urinary catheter or drains.
Postoperatively, a blood test is performed to check haemoglobin levels. During our 16 years of experience, no patient has ever required a blood transfusion after reverse shoulder arthroplasty.
The patient will wear a sling for a few days.
How Many Days of Hospitalisation Are Required?
The patient is discharged from the hospital less than 24 hours after surgery (fast track protocol).
Recovery and Rehabilitation After Surgery
Before discharge from the hospital, the patient will discuss in detail with Dr Leonidou the surgical findings and will receive the relevant booklet with postoperative instructions.
The patient will be monitored by a physiotherapist from our team, following an individualised rehabilitation protocol. Most shoulder movements are permitted from the first postoperative day.
Surgical Success
Shoulder arthroplasty is a demanding surgical procedure and requires a specialised surgeon with a high volume of cases. In experienced hands, it provides excellent results both in eliminating pain and in the patient’s functional recovery.
It is a safe technique with extremely low complication rates. Success rates are high and range between 90–95%.
Relief from acute pain is immediate, and shoulder movement is restored to a great extent.
Return to daily activities is gradual. Within a few days after shoulder arthroplasty, the patient can independently perform the basic movements required for everyday activities.
Lifespan of the Procedure
The correct positioning of the arthroplasty components is an important factor that determines its lifespan. In the hands of specialised shoulder surgeon Dr Leonidou, the lifespan of reverse shoulder arthroplasty reaches 15–20 years in most patie
What Is the Cost and Price? How Much Does the Procedure Cost?
The cost is quite affordable and depends on the complexity of the patient’s condition and the specialised materials required. The cost of the procedure includes the arthroplasty implant, hospital stay expenses, and the fee of the surgical team.
There is also participation from the patient’s insurance fund (EOPYY). Patients with private insurance are covered according to the terms of their insurance policy.
For more information, please contact us.
If you suffer from osteoarthritis and require reverse shoulder arthroplasty, consult the specialised Orthopaedic Surgeon Dr Andreas Leonidou. The doctor has 14 years of continuous experience abroad and specialise
Frequently Asked Questions (FAQs)
What Is Reverse Shoulder Arthroplasty?
It involves replacing the worn articular surfaces of the shoulder (humerus and glenoid). It is indicated in patients with specific types of fractures or arthritis.
What Are the Possible Complications of Shoulder Arthroplasty?
Complications are rare (less than 4%) but may include infection, dislocation, implant loosening, stiffness, or persistent pain. The surgeon’s expertise and proper postoperative care significantly reduce the risk of complications.
How Large Is the Incision and How Long Does the Arm Remain Immobilised?
The procedure is minimally invasive (MIS) and the incision is less than 8 centimetres. Unlike other arthroplasty techniques that require prolonged immobilisation, our patients wear a simple sling for 7 days after surgery.
How Long Does Recovery Take After Shoulder Arthroplasty?
Full recovery may take 3 to 6 months. Most of the shoulder mobility is restored within the first month.
Is Physiotherapy Required After Reverse Shoulder Arthroplasty?
Yes, physiotherapy is essential for restoring shoulder movement and strength. It begins gently after the first few weeks and is gradually adjusted.
What Exercises Are Performed After Shoulder Arthroplasty?
Our clinic has developed a specialised anterior deltoid protocol, which begins on the 8th day after surgery, allowing the arm to be raised quickly. Later, strengthening exercises and functional rehabilitation are introduced.
What Is Robotic Shoulder Arthroplasty and How Does It Differ from Conventional Shoulder Arthroplasty?
Robotic shoulder arthroplasty is an advanced technique in which the surgeon uses robotic systems to plan and perform the procedure with absolute precision. Compared to the conventional method, it offers better adaptation of the prosthesis to the patient’s anatomical characteristics, aiming for improved mobility and reduced pain.
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