Shoulder replacement

Shoulder replacement (shoulder arthroplasty) is a surgical procedure in which the arthritic or damaged surfaces of the shoulder joint are replaced with artificial components. It is indicated when significant arthritis or irreparable rotator cuff damage causes persistent pain and functional limitation that has not responded to non-surgical measures.

Types of shoulder replacement

Anatomic total shoulder replacement

An anatomic total shoulder replacement replaces the humeral head (ball) with a metal implant and resurfaces the glenoid (socket) with a plastic component. It is used when the rotator cuff is intact and the primary problem is glenohumeral arthritis.

Reverse total shoulder replacement

A reverse total shoulder replacement switches the positions of the ball and socket, placing the ball on the glenoid side and the socket on the humeral side. This design allows the deltoid muscle to power arm movement when the rotator cuff is severely torn or non-functional. It is a widely used shoulder replacement design.

Hemiarthroplasty

In selected cases, including acute fractures, replacing only the humeral head without resurfacing the glenoid may be appropriate.

Who may benefit?

• Severe glenohumeral osteoarthritis
• Rotator cuff arthropathy (arthritis combined with a large, irreparable cuff tear)
• Rheumatoid arthritis of the shoulder
• Complex proximal humeral fractures in selected patients
• Failed previous shoulder surgery

The operation

Shoulder replacement is performed under general anaesthesia (usually with a nerve block for pain control) through a deltopectoral incision. The procedure typically takes 90–120 minutes. Hospital stay is typically 1–2 nights.

Recovery

A sling is worn for approximately 4–6 weeks after surgery. Physiotherapy begins early to restore movement before progressing to strengthening. People typically reach comfortable, functional use of the arm by around 3–6 months, with continued improvement over 12 months. Recovery varies between people.