Total Shoulder Replacement (Arthroplasty)

Total shoulder arthroplasty—often called total shoulder replacement—is a surgical procedure that relieves severe shoulder pain and improves shoulder movement when arthritis or joint damage limits daily life. During the surgery, the worn surfaces of the shoulder joint are replaced with an artificial joint, designed to move much like your natural shoulder.

Unlike reverse total shoulder replacement, this procedure keeps the shoulder’s normal ball-and-socket structure. It is often recommended for people who have a healthy rotator cuff but live with shoulder arthritis, stiffness, or pain that no longer improves with physical therapy, medications, or injections.

By recreating smooth movement inside the joint, total shoulder replacement can provide lasting pain relief, better shoulder motion, and a return to everyday activities.

Total shoulder arthroplasty may be recommended when long-term joint damage causes severe shoulder pain or loss of function. Common conditions include:

• Osteoarthritis: Wear-and-tear loss of cartilage causing grinding, swelling, and stiffness.

• Rheumatoid arthritis: An inflammatory disease that damages the joint lining and cartilage.

• Rotator cuff tear arthropathy: A combination of long-standing rotator cuff deficiency and shoulder arthritis.

• Post-traumatic arthritis: Cartilage breakdown after a shoulder fracture, dislocation, or previous injury.

Your orthopedic team evaluates your symptoms, imaging, shoulder movement, and overall health to determine whether total shoulder replacement surgery is the safest and most effective option.

You may be a candidate for shoulder joint replacement if:

• Shoulder pain interferes with sleep, work, or simple daily tasks

• You have limited shoulder movement or feel grinding in the joint

• Non-surgical treatments—like physical therapy, injections, or medications—no longer provide relief

• Imaging shows cartilage loss or bone changes

• Your rotator cuff tendon is strong enough to support an anatomic shoulder replacement

Age, activity level, and expectations all play a role. Your surgeon will discuss whether an anatomic total shoulder replacement, a partial shoulder replacement, or a reverse shoulder replacement is best for your needs.

Total shoulder arthroplasty is a detailed surgical procedure that replaces both sides of the shoulder joint:

1. Incision: A small incision is made at the front of the shoulder.

2. Preparation: The worn ball (humeral head) is removed from the upper arm bone.

3. Socket repair: Damaged cartilage is cleared from the shoulder socket (glenoid).

4. Placement of implants:

   • A prosthetic ball attached to a stem is placed into the arm bone.

   • A smooth plastic socket is secured to the shoulder blade.

5. Closure: Soft tissues and skin are carefully closed to protect the joint.

Each implant is designed to match natural anatomy, improving stability and restoring smoother movement.

Recovery focuses on healing, regaining strength, and restoring shoulder motion.

Immediately After Surgery

• You may wear a sling to protect the joint.

• Pain-relief strategies help you stay comfortable.

Physical Therapy

Physical therapy begins early and is essential for success. Care teams guide:

• Gentle stretching to protect the new joint

• Step-by-step strengthening of the rotator cuff and deltoid muscles

• Gradual return to daily tasks and light activity

Most people notice improvement within weeks, with continued gains over several months.

• Significant pain relief

• Improved shoulder movement and daily function

• Lower stiffness and reduced inflammation

• Ability to return to activities like reaching, lifting light objects, dressing, or grooming

• Stronger and more stable shoulder joint

While most people experience excellent outcomes, all joint replacement surgery carries possible risks:

• Infection or bleeding

• Implant loosening or wear over time

• Nerve irritation

• Stiffness

• Rare need for revision surgery

Your care team will review risks and answer questions to help you make an informed decision.

Some people may benefit from alternatives to total shoulder replacement:

• Reverse total shoulder replacement — recommended for severe rotator cuff deficiency

• Hemiarthroplasty — replaces only the ball of the joint

• Arthroscopic surgery — may address bone spurs or minor tendon issues

• Non-surgical care — medications, injections, or additional physical therapy

Your orthopedic surgeon will help you understand which option supports your goals and long-term shoulder health.

Total shoulder arthroplasty can be life-changing for people living with long-standing shoulder pain, limited movement, and the frustrations of daily discomfort. By replacing the damaged joint with a stable, smooth-moving implant, many patients regain confidence in their shoulder and return to the activities they enjoy.

If severe shoulder pain is disrupting your life, a conversation with a shoulder specialist can help you understand whether total shoulder replacement surgery is right for you.