Introduction

The shoulder prosthesis is divided into two main categories, the inverted shoulder prosthesis and the anatomical shoulder prosthesis. These two types of shoulder prosthesis are completely different both mechanically and in terms of indications. However, there is no specific shoulder prosthesis for the right or left shoulder.

Reverse shoulder arthroplasty

Reverse shoulder arthroplasty surgical philosophy

The reverse shoulder arthroplasty is a French innovation that dates back almost 30 years now. Basically, it allows the shoulder to function even if the rotator cuff is failing.

The articular surfaces are reversed, allowing the humerus to be lowered and the deltoid muscle to function again, which thus compensates the lack of rotator cuff tendons.

Surgery flow

The surgery for the insertion of an inverted total shoulder prosthesis takes about 45 minutes. It is performed by a shoulder surgeon. The surgery can be performed on an outpatient basis or require an overnight stay in hospital.

The scar is approximately 10 centimetres long. The anaesthetist will first put your shoulder to sleep before a light general anaesthesia. Rehabilitation can be done in town; there is no need to go to a rehabilitation centre except in special cases.

Rehabilitation exercises

Rehabilitation of the inverted total prosthesis

Rehabilitation of the inverted total prosthesis - Phase 1

Rehabilitation of the inverted total prosthesis - Phase 2

Rehabilitation: total shoulder prosthesis reversed

These dates are only indicative.
All rehabilitation evolves at its own pace.

Week 1 to 3

● Minimum use of the arm (= simple everyday activities: washing/dressing/eating)

● A resting sling is worn at night (you can take the spling off for a few hours during the day)

● Rehabilitation with the physiotherapist 3 times a week

● Self-rehabilitation exercise to be done 5 times a day

● Maximum 30 minutes' walking per day (no long walks)

Week 4 to 6

● Picking up light objects

● Nothing heavy, nothing repetitive, no cleaning

● Rehabilitation with the physiotherapist 3 times a week

● Self-rehabilitation exercises to be done 5 times a day

● Maximum 45 minutes' walking per day

Week 7 to 12

● Use of the arm in simple activities of daily living (washing/dressing/eating)

● Resume driving

● Rehabilitation with the physiotherapist 1 to 2 times a week

● Self-rehabilitation exercises to be done 5 times a day

From 3 to 6 months

● Resume housework, go swimming

From 6 months

● Resume physical activities, gardening, etc.

The anatomical shoulder arthroplasty

Description

Anatomical shoulder arthroplasty surgical philosophy

The anatomical shoulder arthroplasty aims to reproduce the anatomy of the shoulder as it was before the disease. The initial shoulder will be reconstructed with near custom-made implants. There are no specific implants for the right or left shoulder.

Sometimes a pyrocarbon implant is used. This procedure gives very good results, but the tendons of the rotator cuff must be of very high quality.

Surgery flow

The anatomical shoulder arthroplasty procedure is usually performed in one day at the hospital, one or two nights can be spent in the facility.

The incision is 10 centimetres long. The anaesthetist will start by performing locoregional anaesthesia (to improve postoperative comfort), then general anaesthesia. There is no need to stay in a rehab center.  

Rehabilitation: anatomical shoulder arthroplasty

These dates are only indicative.
All rehabilitation evolves at its own pace.

Week 1 to 3

● A simple splint is worn day and night (with the exception of dressing, washing, eating, physiotherapy sessions and self-rehabilitation exercises)

● Rehabilitation with a physiotherapist 3 times a week

● Self-rehabilitation exercises to be done 5 times a day (1 minute per exercise)

● No more than 30 minutes' walking

Week 4 to 6

● A splint is worn day and night then progressively removed in the 4th week (1 hour in the morning/1 hour in the afternoon, then increased very gradually)

● Self-rehabilitation exercises to be done 5 times a day (1 minute per exercise)

● Rehabilitation with a physiotherapist 3 times a week

● No prolonged or excessive walking

Week 7 to 12

● No more splint

● Minimum use of the arm (= simple activities of daily living)

● Picking up light objects

● Nothing heavy, nothing repetitive, no cleaning, no dishes

● Resume driving around 1 and a half months

● Rehabilitation with a physiotherapist 3 times a week

● Self-rehabilitation, start exercises 4–6 weeks, 5–8 weeks, 6–10 weeks, 7–12 weeks

● Maximum 45 minutes' walking

From 3 to 6 months

● Resume housework gradually, cycling/exercise bike, swimming, walking

● Rehabilitation with the physiotherapist twice then once a week

● All self-rehabilitation exercises

From 6 months

● Physical activities, carrying loads, DIY, gardening