Shoulder joint replacement surgery is not nearly as common as hip and knee replacement. But for Joan Fischer of Fayetteville, it was just as much of a necessity. For years, pain in her shoulder made even the simplest tasks difficult.

"Writing was difficult," Fischer said. "I had to be very careful not to pick up anything that was heavy because it dragged my shoulder down. Even brushing my teeth [was hard]."

Fischer was a prime candidate for shoulder joint replacement, or arthroplasty. But arthritis had destroyed her rotator cuff, the group of muscles that work together to rotate the arm.

"In cases where patients have a torn rotator cuff, or they develop severe arthritis and their rotator cuff does not function anymore, we have to use a non-traditional replacement," said Dr. Stephen Kouba of Cape Fear Orthopaedic Clinic.

Kouba was the first orthopaedic surgeon in Fayetteville to use the Reverse Joint Replacement for shoulder surgery. Unlike traditional joint replacement, where the socket of the implant goes into the shoulder and the ball goes in the arm, the reverse procedure does just that. The ball goes into the shoulder and the socket goes into the arm.

Without the damaged rotator cuff, the patient has no pain. But the tradeoff is months of rehab, to teach muscles to work in a new way.

"It's a way of trying to keep them independent," said Kouba. "But the biggest thing that I've discovered over the past year is that it really relieves their pain."

Fisher is living proof. After four months of rehab, she has slowly regained strength and function in her arm, but she said the best part is being pain-free. That makes the rehab exercises easier to bear and helps her push on to her goal.

"One of the things I haven't been able to do is ride my bicycle," said the 78-year old. "And that's not because I can't peddle it. It's because of the weakness in the shoulder. I can't push myself up onto the bicycle. So that's been one of my goals - to be able to ride my bicycle again."

Click on the video link above to hear more from Dr. Stephens about the Reverse Joint Replacement Surgery and what patients can expect.

You can watch video of the Shoulder Joint Replacement procedure by clicking on the video link above.