How a reverse shoulder replacement works

Illustration simplified and not to scale.

Who is it for?

A reverse shoulder replacement is commonly recommended for:

• Rotator cuff arthropathy – arthritis that develops after a long-standing rotator cuff tear
• Massive rotator cuff tears that can’t be repaired, particularly when you can’t lift your arm
• Arthritis with a badly worn socket
• Complex fractures of the top of the arm bone, particularly in older people
• Revision of a previous shoulder replacement or failed fracture fixation

It is also an option for osteoarthritis when the rotator cuff is intact, particularly in older people. A large English registry study of people aged 60 and over found reverse and anatomic replacements had similar function, complications and long-term revision rates in this group, with fewer reoperations in the first year after a reverse replacement.³

Whether a reverse replacement suits you depends on your examination, your scans and your goals. See which shoulder replacement is right for me?

What to expect from the result

A reverse replacement is mainly designed to relieve pain and restore the ability to lift the arm.

• In a review of 365 reverse replacements for massive rotator cuff tears, followed for an average of 9.5 years, shoulder scores and the ability to lift the arm improved substantially, and did not deteriorate between 5 and 20 years after surgery.²
• The same improvement has been shown in people under 60, followed for an average of almost 12 years.⁴
• In the Australian joint replacement registry, between 93% and 97% of reverse replacements, depending on the implant combination, had not needed revision 10 years after surgery.¹

Lifting the arm forwards and to the side usually improves the most. Turning the arm outwards and reaching behind the back usually improve less, and this is worth discussing before surgery if those movements matter to you.²

How Dr Brumby-Rendell performs it

1. 3D planning from a CT scanEvery operation is planned on a 3D model of your shoulder before the day of surgery, setting the size, angle and position of the implant.
2. Mako robotic assistanceIn theatre, the robotic arm helps prepare the shoulder socket to the 3D plan. See robotic-assisted shoulder replacement.
3. Mini incisionThe operation is performed through a minimally invasive approach, which aims to limit disruption to the surrounding muscle.
4. Bone-preserving implantDr Brumby-Rendell uses a bone-preserving mini reverse shoulder replacement, with a short humeral component that keeps more of your own arm bone.

In hospital and recovery

Reverse shoulder replacement is performed at Eastwood Private Hospital. Most patients stay two days. A physiotherapist sees you on the morning after your operation to start your exercises, and your full recovery plan is explained before surgery.

• Sling – usually worn for 2 to 4 weeks
• Driving – usually avoided for several weeks
• Heavy lifting – usually from 8 to 12 weeks or more

Follow-up includes a review with an X-ray at 12 months. See post-surgery care.

Risks

All surgery carries risks, including infection, dislocation, fracture, loosening of the implant and nerve injury. Dr Brumby-Rendell will go through these with you in detail at your consultation, including how they apply to your shoulder.

Reverse replacement for fractures

For badly displaced fractures of the top of the arm bone in older people, a reverse replacement is increasingly used. A 2026 randomised trial of 80 people aged 60 to 90 found better shoulder scores, less disability and better arm elevation at one year with a reverse replacement than with non-surgical treatment.⁵

Dr Brumby-Rendell was the first surgeon in Australia to use a new fracture stem for proximal humerus fractures. See proximal humerus fractures.

Frequently asked questions

How long does a reverse shoulder replacement last?

In the Australian joint replacement registry, between 93% and 97% of reverse shoulder replacements, depending on the implant combination, had not needed revision 10 years after surgery. Long-term studies show the improvement in function is maintained for 10 years and beyond.

Will I be able to lift my arm above my head?

Most people can lift their arm considerably higher after a reverse replacement than before. Turning the arm outwards and reaching behind the back usually improve less.

Is a reverse shoulder replacement done robotically?

Reverse shoulder replacements can be performed with Mako robotic assistance at Eastwood Private Hospital. The robotic arm helps prepare the shoulder socket exactly as planned in 3D.

How long will I be in hospital?

Most patients stay two days. A physiotherapist sees you on the morning after your operation to start your exercises.

Do I need a referral?

Yes. A referral from your GP or another specialist is needed to claim a Medicare rebate for a specialist consultation. Once you have one, you can book online or call (08) 7077 0101.