Shoulder replacement surgery, also referred to as shoulder arthroplasty, is a surgical procedure that involves the removal of the affected parts of the shoulder joint and replacing them with an artificial one. This surgery is usually recommended when other treatments like medication, physiotherapy or conservative surgeries have failed to bring relief from pain or enhance functionality. Some of the causes that may warrant a shoulder replacement are severe arthritis, rotator cuff tear arthropathy, fractures, and osteonecrosis.

Shoulder Replacement Surgery Options

1.     Total Shoulder Replacement (Anatomic)

·        This is where both the ball (humeral head) and the socket (glenoid) of the shoulder joint are replaced.

·        Recommended for patients with healthy rotator cuff muscles and tendons.

2.     Reverse Total Shoulder Replacement

·        The positions of the ball and socket are swapped; the ball is positioned on the scapula, while the socket is positioned on the humerus.

·        Indicated for patients with extensive rotator cuff tear or those who have had a conventional shoulder replacement surgery.

3.     Partial Shoulder Replacement (Hemiarthroplasty)

·        The head of the bone is removed and replaced with a prosthesis.

·        Used in the management of fractures where the socket is still viable or in cases of arthritis limited to the humeral head.

Indications for Shoulder Replacement

·        Osteoarthritis: Osteoarthritis that results in pain and rigidity of the joint.

·        Rheumatoid Arthritis: A type of arthritis that results from the immune system attacking the body’s tissues and leading to inflammation of the joints.

·        Post-traumatic Arthritis: Arthritis happening after an accident.

·        Severe Fractures: Complicated shoulder fractures that are hard to fix.

·        Avascular Necrosis: The death of bone tissue because of inadequate blood flow.

·        Failed Previous Shoulder Surgery: Chronic pain and disability following prior surgical interventions.

Procedure Overview

1.     Preoperative Evaluation:

·        Full examination consisting of anamnesis, a general and neurological examination, and imaging (X-rays, MRI) and occasionally blood tests.

·        Risks, benefits, and expectations.

2.     Surgery:

·        Usually done under general anesthesia.

·        The surgeon cuts through the skin of the shoulder, removes the worn out parts of the joint and implants new artificial parts.

·        Duration: About 1-2 hours.

3.     Postoperative Care:

·        Pain control through the use of drugs.

·        The management includes the following: Initial immobilization of the shoulder in a sling.

·        Gradual rehabilitation including physical therapy to restore movement and strength.

·        Retreatment appointments to check on the recovery and improvement.

Risks and Complications

·        Infection: As with any surgery, there is always a risk, albeit a small one.

·        Blood Clots: Reduced risk due to early mobility and taking of medication.

·        Prosthesis Problems: Dislocation, wear or loosening of the artificial parts.

·        Nerve Injury: Though not common, it can happen and impair shoulder movement.

·        Stiffness or Limited Range of Motion: Nevertheless, surgery, and even rehabilitation measures.

Outcomes and Prognosis

·        The majority of the patients reported reduced pain and increased shoulder mobility.

·        The lifespan of the prosthesis is different and most of them can last for 10-20 years.

·        The outcome of the therapy depends on variables such as the degree of joint damage, compliance to physiotherapy, and general health condition.


Shoulder replacement is a very successful surgery for people who have severe shoulder problems and who have not been helped by other treatments. It is advisable to consult with an orthopedic surgeon to identify the best type of shoulder replacement that suits the patient’s condition and medical history.