For a reverse shoulder replacement procedure, much of the surgery is the same as the total shoulder replacement. The shoulder joint is a ball-and-socket joint that consists of a ball at the top of the arm bone (humerus) that fits into a socket at the shoulder blade (scapula). A reverse shoulder replacement uses an artificial device to replace the damaged shoulder joint in a reversed manner — a ball at the shoulder and a socket at the end of the arm. A hole is made down the center of the arm bone to insert the stem of the socket implant and secure it with special cement. A ball-shaped implant is affixed to the socket of the shoulder blade using screws. Proper alignment of these two pieces is critical to the success of the surgery. Any imbalance will cause rotation issues that can result in damage to the shoulder.
The difference in therapy between a total shoulder replacement and a reverse total shoulder replacement is that with the reverse, patients do not start therapy until after six weeks of rest, to where with a total shoulder replacement patients start therapy a week after surgery.