Reverse total shoulder replacement is usually the route when instability and bone loss rule out the standard prosthesis. It changes the mechanics so the deltoid picks up the slack where the cuff can't. The adjustment period is real, but many patients report better function than they expected. If you're looking into it, I'd recommend checking in with this shoulder doctor, he's very transparent about what the procedure can and can't give back, and that honesty helps you plan your life around the recovery.
