In plain language
What is total shoulder replacement?
Shoulder replacement removes the worn surfaces of the ball-and-socket joint and replaces them with artificial components. In an anatomic replacement, a new ball is attached to the upper arm bone and a plastic socket is fitted to the shoulder blade. A reverse replacement changes this arrangement and may be considered when the rotator cuff cannot reliably power the shoulder. The design must match the diagnosis, bone quality and tendon function.Who it may help
When might it be considered?
- Advanced shoulder arthritis with persistent pain, stiffness and sleep disturbance
- Loss of useful shoulder movement despite appropriate medication, injections and rehabilitation
- Selected complex upper-humerus fractures
- Cuff-tear arthropathy or failed previous surgery where a reverse replacement is more suitable
Before surgery
What may be considered first?
- Activity modification and pain medication where appropriate
- Structured shoulder rehabilitation
- Selected injection treatment
- Arthroscopy for specific repairable problems rather than advanced arthritis
- Continued observation when symptoms remain manageable
Inside the operating theatre
What actually happens during the operation?
Planning the correct replacement
Examination and imaging assess the joint surfaces, bone shape and rotator cuff. These findings help the surgeon choose an anatomic or reverse design and plan implant size and position.
Reaching the joint
Through an incision at the front of the shoulder, the surgeon works carefully around the deltoid, rotator cuff, nerves and blood vessels to expose the damaged joint.
Replacing the worn surfaces
The damaged humeral head is prepared for a metal stem or stemless component. In an anatomic replacement, a new ball and plastic socket recreate the normal arrangement; a reverse replacement uses a ball on the socket side and a cup on the arm side.
Checking movement and stability
The surgeon tests implant position, soft-tissue tension, stability and movement before repairing the tissues and closing the wound.
Protecting healing tissues
A sling protects the shoulder early. The rehabilitation plan depends on the implant, rotator cuff work, bone quality and any fracture repair.
After the operation
What does recovery involve?
Hand, wrist and elbow movement usually starts early while the shoulder is protected in a sling.
Shoulder movement progresses in stages under the surgeon and therapist's guidance; strengthening begins only when the repair and soft tissues are ready.
Comfort and everyday function often improve over months, while final strength and movement depend on the original diagnosis and tissue quality.
Informed consent
Important risks to understand
- Infection
- Stiffness
- Nerve or blood-vessel injury
- Fracture
- Instability or dislocation
- Rotator-cuff or tendon failure
- Implant wear or loosening
- Persistent pain
- Need for revision surgery
This is a general guide, not a complete consent discussion. Your surgeon will explain risks specific to your diagnosis, health, anatomy and proposed technique.
Common patient questions
Questions people often ask
What is the difference between anatomic and reverse shoulder replacement?+
An anatomic replacement recreates the normal ball-and-socket arrangement and depends on a functioning rotator cuff. A reverse replacement changes the geometry so the deltoid can help lift the arm when the cuff is irreparable or in other selected situations.
Will I regain full movement?+
Not always. The aim is reliable pain relief and useful function. Final movement depends on pre-operative stiffness, tendon quality, bone, implant type and rehabilitation.
How long will I use a sling?+
This varies with the operation and tissue repair. Your surgeon will set a staged plan for sling use, movement and strengthening.
Clinical references
These independent patient resources informed the general explanation above.