Going in Reverse

How a Reverse Total Shoulder Replacement Made All the Difference

When you can’t use your arm, the world can be a very difficult place. Francesca Cappara, of Avon Lake, knows this firsthand. A rotator cuff tear and bicep tear left her unable to do life’s most basic tasks for years. The pain and loss of strength in the shoulder made preparing meals an arduous task. Even opening a car door was difficult.

“I wish I would have found Dr. Gobezie years ago,” said Fran, age 66. “It would have saved me many years of pain and suffering.”

Five years ago, Fran had arthroscopic surgery to repair the rotator cuff tear by a different orthopedic surgeon in the Cleveland area. He was not able to reattach the bicep and said the repair would unfortunately not last long. Fran felt slightly better after this surgery, but still felt pain and loss of function. Over time, things grew progressively worse.

“It seriously affected all my activities of daily living and was causing me to become depressed because I felt like I was no longer functioning normally,” Fran said. “I couldn’t even get a cup of coffee out of the microwave any longer, or cut up fruits and vegetables, let alone dressing or normal hygiene routines.”

A friend referred her to Dr. Gobezie.

“The best option to restore the most function for Fran was to have a reverse total shoulder replacement,” said Dr. Gobezie. “Patients do extremely well with this procedure, and I usually recommend it for patients who have an irreparable rotator cuff tear or a previous failed rotator cuff surgery.”

“Dr. Gobezie gave me hope that I would be able to do the things that I enjoyed again,” Fran said. “Can’t believe how much it has improved my life. I am able to move pain free and have regained most of the strength in my right arm that I had lost.”

Putting it in reverse

Reverse total shoulder replacement surgery is unique in that it changes the orientation of the shoulder so that the normal socket (glenoid) now is replaced with an artificial ball, and the normal ball (humeral head) is replaced with an implant that has a socket into which the artificial ball rests. This type of design completely changes the mechanics of the shoulder and enables the artificial joint to function when the rotator cuff is either absent or when there is significant bone loss.

The benefit of the reversal of the shoulder joint is that it allows the deltoid muscle to lift the shoulder instead of the rotator cuff, which cannot lift due to irreparable tear. Reversing the ball and socket improves active range of motion and strength. The result is that the patient can raise his/her arm higher and even sometimes overhead.

Studying our patients after surgery

As part of his ongoing research and development of best practices, Dr. Gobezie keeps in touch with his patients following surgery to monitor pain and function. His studies of patients with reverse total shoulder replacement surgery has shown that on average, patients rate their shoulder at 31% of normal at their first visit. After surgery, they rate their shoulder at about 73% of normal.  Reported pain levels are an average of 6 out of 10 prior to surgery. This decreases to an average of 2 following the procedure.

In Fran’s case, Dr. Gobezie was able to reattach the bicep, and she now reports exceptional results.

“My mobility and quality of life has improved significantly,” Fran said. “I am doing things again that I haven’t been able to do for over 8 years easily. I can dig a hole in the garden to plant a tulip bulb, which used to cause difficulty because I had no strength in my painful right arm. Preparing meals is a breeze again, and I don’t dread it or have to ask my husband to cut things up for me. The simplest things such as opening a car door improved. This may be minor improvements to some people but to me it is a miracle.”

Fran said that while recuperation can take about a year, she feels near full function at eight months post operation.

Would she recommend Dr. Gobezie to others?

“I have and always will,” she said. “My experience with Dr. Gobezie was wonderful. At the first meeting he immediately impressed me. Dr. Gobezie gave me hope that I would be able to do the things that I enjoyed again. I felt that he was a kind and caring surgeon and would resolve my problem with confidence. He has helped me tremendously and I can’t thank him enough.”

 

For more details on the reverse total shoulder replacement surgery, visit:

https://clevelandshoulder.com/reverse-total-shoulder-replacement-surgery/