Total, Partial and Reverse Shoulder Replacement
In arthritis, massive rotator cuff tears or complex fractures, the shoulder joint can be replaced. The type of implant is chosen according to the condition of the tendons.
Shoulder replacement renews a painful, stiff shoulder joint with artificial parts. Although it is less common than knee and hip replacement, in the right patient it is an effective way to relieve pain and regain everyday function.
When is a shoulder replacement needed?
- Advanced shoulder arthritis (glenohumeral osteoarthritis)
- Joint damage caused by rotator cuff tears too large to repair (cuff tear arthropathy)
- Rheumatoid arthritis and other inflammatory joint diseases
- Avascular necrosis of the humeral head
- Complex fractures of the humeral head that cannot be fixed, especially in older people
- Joint damage after previous operations
Types of shoulder replacement
Total (anatomic) shoulder replacement
The head of the upper arm bone is replaced with a metal head and the socket with a special plastic component, recreating the natural anatomy. The rotator cuff tendons need to be intact.
Partial shoulder replacement (hemiarthroplasty)
Only the head of the upper arm bone is replaced and the socket is kept. It may be chosen for some fractures and for necrosis when the socket is healthy.
Reverse shoulder replacement
The structure of the joint is reversed: a ball is fixed to the socket and a cup to the upper arm bone. This lets the deltoid muscle lift the arm even when the rotator cuff does not work. It is widely used for massive rotator cuff tears, some fractures in older people and revision surgery.
Diagnosis and planning
Range of motion and tendon strength are assessed on examination. X-rays and CT show the joint surfaces and the bone of the socket. MRI is used to check the rotator cuff. The type of implant is chosen from these findings.
Surgery and recovery
The operation is done under general anaesthesia with a nerve block and usually takes a few hours. The hospital stay is generally short.
- First weeks: Sling, hand and elbow exercises, controlled shoulder movement with a physiotherapist
- After week 6: More active movement, gradual return to daily tasks
- After month 3: Muscle strengthening and improving function
Heavy lifting and impact sports are best avoided after a shoulder replacement. Swimming, walking and golf are possible for most patients.
Possible risks
Infection, dislocation, nerve injury, fracture around the implant and long-term loosening are the possible risks. They are discussed in detail, in relation to your own health, before surgery.
Life at home after surgery
In the first weeks, help may be needed with dressing, washing and preparing meals. Front-buttoning clothes, long-handled bath sponges and keeping frequently used items at waist height make daily tasks easier.
Frequently asked questions
Can I lift my arm after a reverse shoulder replacement?
The reverse design lets patients whose rotator cuff does not work lift the arm using the deltoid muscle. Most patients can lift the arm above shoulder height.
How long does a shoulder replacement last?
Most shoulder implants work well for many years. Activity level and bone quality affect their lifespan.
Is physiotherapy essential?
Yes. Regular physiotherapy plays a decisive role in the result, and the programme differs by implant type.
Can I drive after a shoulder replacement?
Once the sling is no longer needed and shoulder control is adequate, driving is possible with your surgeon's approval.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.