What it is
The shoulder is a ball-and-socket joint: the ball at the top of the arm bone (humerus) moves against a shallow socket on the shoulder blade (glenoid). Both are covered with smooth cartilage. When that cartilage is lost, bone rubs on bone and the joint becomes painful and stiff.
Shoulder replacement, or arthroplasty, removes the damaged joint surfaces and replaces them with implants made of metal and medical-grade plastic. It may be considered for osteoarthritis, inflammatory arthritis such as rheumatoid arthritis, arthritis after an earlier injury, rotator cuff tear arthropathy (arthritis combined with a large rotator cuff tear that cannot be repaired), loss of blood supply to the humeral head (avascular necrosis), and some complex fractures of the upper arm bone.
Three styles of replacement
No single implant is right for every shoulder. Kasey Komperda, MD, FAAOS performs all three styles, so the choice can follow your anatomy, your rotator cuff and your goals.
Anatomic total
- The ball is replaced with a polished metal head and the socket is resurfaced with a plastic component, recreating the shoulder’s natural shape.
- Generally best suited to shoulders with a healthy, working rotator cuff.
Reverse total
- The positions are reversed: a metal ball is fixed to the socket side and a cup to the arm bone.
- This lets the deltoid muscle lift the arm, making it an option when the rotator cuff is torn beyond repair, for some complex fractures and for some revision surgeries.
Partial (hemi)
- Only the ball is replaced; your natural socket is kept.
- May be considered in selected situations, such as when the socket cartilage is still healthy or for certain fractures.
When to consider replacement
- Deep, aching shoulder pain that limits daily activities
- Pain at night that disrupts sleep
- Stiffness and loss of motion, such as difficulty reaching overhead or behind your back
- Grinding, catching or clicking with movement
- Symptoms that persist despite therapy, medication and injections
Evaluation
Evaluation begins with a detailed history and an examination of shoulder motion and rotator cuff strength. X-rays show the extent of arthritis. A CT scan is often used to study the shape of the socket and plan implant position, and MRI may be used to assess the rotator cuff. Your overall health and medications are reviewed so that surgery, if chosen, is as safe as possible.
Treatment options
Non-surgical
- Activity modification to reduce painful loading
- A guided physical therapy program to maintain motion and strength
- Anti-inflammatory medication when appropriate
- A corticosteroid injection in selected cases
Surgical
- Anatomic total shoulder replacement for arthritis with a functioning rotator cuff.
- Reverse total shoulder replacement for cuff tear arthropathy, irreparable rotator cuff tears, some fractures and some revisions.
- Partial (hemi) arthroplasty in selected cases.
- Replacement is usually considered when pain and loss of function persist despite non-surgical care and meaningfully affect quality of life.
Recovery
- First weeks
Many patients go home the same day or after a short hospital stay. The arm is protected in a sling, typically for several weeks.
- Early rehab
Physical therapy begins with gentle, guided movement to restore motion while the soft tissues heal.
- Strengthening
Strengthening is added gradually, usually a couple of months after surgery.
- Full recovery
Many patients return to most daily activities within several months, and improvement can continue for up to a year. Depending on the implant, some long-term activity precautions may be recommended.
Timelines are typical ranges, not guarantees. Recovery depends on the specific injury, the procedure, your health and your rehabilitation, and your plan is individualized.
Questions patients ask
Which type of replacement will I need?
It depends on the condition of your rotator cuff, the shape of your bone, the cause of your arthritis and your activity goals. The choice is made together after an examination and a review of your imaging.
How long does a shoulder replacement last?
Modern implants are durable, and many last for years, but any replacement can wear or loosen over time. Longevity depends on factors such as activity level, bone quality and the type of implant.
Is there an age limit?
Age is one factor among many. Younger, very active patients are counselled carefully about non-surgical options and long-term activity expectations before surgery is chosen.
This page is general patient education and is not a substitute for an in-person evaluation.