Reverse Total Shoulder Replacement (RTSA)
An advanced shoulder replacement in which the ball-and-socket positions are reversed — allowing the deltoid muscle to restore arm movement when the rotator cuff is severely damaged.
What is Reverse Total Shoulder Replacement (RTSA)?
Reverse Total Shoulder Replacement (RTSA) is an advanced shoulder replacement surgery used to treat patients with severe shoulder arthritis combined with significant rotator cuff damage. When the rotator cuff tendons are torn or no longer functioning properly, conventional shoulder replacement may not provide adequate stability or arm movement. In RTSA, the normal ball-and-socket structure of the shoulder joint is reversed — a metal ball is attached to the shoulder socket (glenoid) and a socket component is placed on the upper arm bone (humerus). This design allows the deltoid muscle to take over the role of lifting the arm, compensating for the damaged rotator cuff and restoring meaningful arm elevation and daily function.
How the Procedure Works
Pre-operative Imaging & Planning
X-rays and MRI assess the severity of arthritis and rotator cuff damage; implant sizing is planned and anaesthesia is administered on the day of surgery.
Surgical Access
A carefully planned incision over the shoulder exposes the damaged joint; surrounding muscles and soft tissues are gently moved aside.
Removal of Damaged Joint Surfaces
Worn-out cartilage and damaged bone from the humeral head and glenoid socket are removed to prepare both surfaces for the reversed prosthetic components.
Glenoid Ball Component Placement
A metal ball component is fixed to the glenoid (shoulder socket), reversing the normal anatomy and creating the new fulcrum for joint movement.
Humeral Socket Component Placement
A socket-shaped implant is fixed to the humerus; this configuration allows the deltoid muscle to power arm elevation and stabilise the joint.
Stability Testing & Wound Closure
Shoulder stability, alignment, and range of motion are confirmed; the incision is closed with sutures and the arm is placed in a sling.
Outcomes
Who Needs This Treatment?
- →Specifically engineered for patients with combined arthritis and rotator cuff failure
- →Restores arm elevation and movement even when the rotator cuff cannot function
- →Significantly reduces chronic, disabling shoulder pain
- →Improves ability to perform daily tasks including some overhead activities
- →Durable, long-lasting implant construction
- →Physiotherapy after surgery maximises functional shoulder recovery
“Reverse shoulder replacement has transformed outcomes for patients with both severe arthritis and rotator cuff failure. By reversing the mechanics of the joint, we allow the deltoid to do the work the cuff can no longer do — giving patients back their independence and quality of life.”
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic & Trauma Surgeon, Lux Hospitals, Hyderabad
Common Questions
Frequently Asked
Not sure which treatment is right for you?
Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.