What Is Shoulder Replacement Surgery and What Should You Expect?

Shoulder replacement surgery removes damaged bone and cartilage from the shoulder joint and replaces them with artificial components. It is typically considered when severe arthritis, rotator cuff damage, or other joint disease causes pain and loss of function that no longer respond to nonsurgical treatment. The type of replacement—total, partial, or reverse—depends on which parts of the joint are damaged and whether the rotator cuff is intact. Recovery involves a sling, gradual physical therapy, and several months before full function returns.

What Shoulder Replacement Surgery Treats

The procedure addresses conditions that damage the ball-and-socket structure of the shoulder:

• Severe osteoarthritis — cartilage wears away, causing bone-on-bone pain and stiffness
• Rheumatoid arthritis — inflammatory joint disease that erodes cartilage and bone
• Rotator cuff tear arthropathy — long-standing rotator cuff tears that allow the joint to collapse
• Avascular necrosis — loss of blood supply causes the ball of the shoulder to collapse
• Complex fractures — certain breaks of the upper arm bone near the joint
• Failed previous surgery — when an earlier repair no longer controls symptoms

When Surgery Is Recommended vs. Nonsurgical Options

Surgery is generally not the first step. Most surgeons recommend trying conservative treatment first:

Surgery becomes a reasonable option when pain interferes with sleep, daily activities, or quality of life despite months of nonsurgical treatment, or when imaging shows advanced joint destruction.

Types of Shoulder Replacement

The choice of procedure depends on the specific problem:

Total Shoulder Replacement (Anatomic)

Both the ball (humeral head) and socket (glenoid) are replaced with components that mimic normal anatomy. Best for patients with an intact rotator cuff and arthritis mainly affecting the joint surfaces.

Partial Shoulder Replacement (Hemiarthroplasty)

Only the ball is replaced. The socket is left intact. Used when the socket cartilage is still healthy, such as in some fractures or avascular necrosis.

Reverse Total Shoulder Replacement

The ball and socket positions are switched—the ball is placed on the socket side and the socket on the arm side. This design allows the deltoid muscle to power the arm when the rotator cuff is torn or nonfunctional. It is the preferred option for rotator cuff tear arthropathy and some complex fractures.

What to Expect Before, During, and After Surgery

Before Surgery

• Medical evaluation and imaging (X-rays, sometimes CT or MRI)
• Blood tests and possibly cardiac clearance
• Instructions to stop certain medications
• Planning for home support and recovery time

During Surgery

• Usually performed under general or regional anesthesia
• Takes about 1–2 hours
• The surgeon removes damaged bone and cartilage and implants the artificial components
• May be done as an inpatient or outpatient procedure depending on the facility and patient

After Surgery

• Hospital stay: Often 1–2 days, sometimes same-day discharge
• Sling: Worn for several weeks to protect the repair
• Physical therapy: Begins soon after surgery, starting with gentle motion and progressing to strengthening
• Recovery timeline:
  • 0–6 weeks: Sling, passive motion, pain control
  • 6–12 weeks: Active motion, light activities
  • 3–6 months: Strengthening, return to many daily activities
  • 6–12 months: Full recovery for most patients

Risks and Complications to Watch For

As with any surgery, there are risks:

• Infection
• Blood clots
• Nerve or blood vessel damage
• Implant loosening or wear over time
• Dislocation (especially with reverse replacement)
• Stiffness or persistent pain
• Fracture around the implant

Contact your surgeon promptly if you notice:

• Fever or chills
• Increasing redness, warmth, or drainage from the incision
• Sudden severe pain or inability to move the arm
• Numbness or weakness in the hand or fingers
• Calf pain or swelling

Choosing a Facility

Kansas Surgery & Recovery Center is a physician-owned orthopedic specialty hospital that consistently ranks high for joint replacement surgery by HealthGrades, an independent health care rating company. The facility offers total shoulder surgery among its services and provides patient information, financial planning, and price transparency resources. For questions or to discuss whether shoulder replacement is right for you, contact your physician or the facility directly.