Reverse Total Shoulder Replacement (RTSA)
The ball and socket of the shoulder are mechanically reversed — placing the prosthetic ball on the socket side — enabling the deltoid muscle to power shoulder movement when the rotator cuff is absent or non-functional.
What is Reverse Total Shoulder Replacement (RTSA)?
Reverse total shoulder replacement inverts the normal ball-and-socket arrangement — a metal sphere (glenosphere) is fixed to the glenoid side while a polyethylene cup is mounted on the humeral stem. This shift in the centre of rotation lengthens the deltoid muscle's mechanical arm and positions it to drive shoulder elevation independently of the rotator cuff. The result is functional shoulder movement even when the cuff is completely absent or irreparably destroyed. Dr. Sai Kishan performs RTSA at Lux Hospitals for patients with rotator cuff arthropathy, massive irreparable cuff tears with pseudoparalysis, failed previous shoulder replacements, and complex proximal humerus fractures in selected patients.
How the Procedure Works
Anaesthesia & Surgical Preparation
General anaesthesia with interscalene block for post-operative pain management; beach-chair positioning for standard deltopectoral access.
Deltopectoral Approach
A standard anterior incision provides access; the subscapularis is released; the humeral head is dislocated and the damaged head is resected.
Glenoid Baseplate & Glenosphere
The glenoid surface is reamed and prepared; the baseplate is fixed with central peg and peripheral screws; the glenosphere is attached.
Humeral Preparation & Stem Insertion
The humeral canal is broached to size; the stem is inserted and the trial polyethylene cup is attached to assess stability and range of motion.
Final Components & Closure
Final components are assembled; subscapularis repair is performed where tissue permits; wound is closed and a sling applied.
Outcomes
Who Needs This Treatment?
- →Reliable pain elimination from rotator cuff arthropathy and massive cuff tears
- →Restores active shoulder elevation in patients who cannot lift their arm overhead
- →Purpose-designed mechanics compensate for an absent or non-functional rotator cuff
- →Contemporary implant design delivers excellent long-term stability and durability
- →Suitable for complex proximal humerus fractures in older or osteoporotic patients
- →Consistently high patient satisfaction scores in all age groups treated
Reverse shoulder replacement has been truly transformative — patients who could not lift their arm to shoulder height before surgery are often washing their hair and driving within months. That change in independence is remarkable.
— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery
Common Questions
Frequently Asked
Not sure which treatment is right for you?
Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.