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Total Shoulder Replacement

Understand the Shoulder & Its Joints

The shoulder is a ball-and-socket joint that enables you to raise, twist and bend your arm. It also lets you move your arm forward, to the side and behind you. In a normal shoulder, the rounded end of the upper arm bone (humeral head) glides against the small dish-like socket (glenoid) in the shoulder blade (scapula). These joint surfaces are normally covered with smooth cartilage. They allow the shoulder to rotate through a greater range of motion than any other joint in the body.

Indicators for a Total Shoulder Replacement

The most common indication for total shoulder replacement is shoulder pain due to arthritis or degenerative joint disease that cannot be controlled with non-operative treatment. Accompanying the pain is a progressive stiffness and loss of motion and/or a grinding or grating sensation.

Benefits of a Total Shoulder Replacement

The primary benefit is pain relief, with a secondary benefit of restoring motion, strength, and function. Pain relief, however, is the most predictable benefit of shoulder replacement, gains in range of motion and strength are less predictable. Partial shoulder replacement (hemi-replacement) may also be indicated with certain severe shoulder fractures of the humeral head.

During and After the Procedure

Total shoulder replacement involves replacing the joint ball and the socket with an implant (prosthesis). There are many different types of implants, and your orthopedic surgeon will decide which is best for you. Implants contain a ball with a stem that extends down inside the patient’s upper arm bone (humerus) and a socket that is placed over the surface of the patient’s glenoid.

The most recently developed implants allow for the new humeral head to conform to the patient’s exact anatomy, and a cementless stem that allows for the ingrowth of bone into the prosthesis. Depending on the condition of the shoulder, your surgeon may replace only the ball. Sometimes this decision is made in the operating room at the time of the surgery.

You will be admitted as an inpatient, and the procedure will be done in one of Hoag’s state-of-the-art operating rooms. It will likely take around two hours, and will be done under general or regional anesthesia. Your inpatient stay will be from two to three days. Based on the range of motion and stability of the implant, limited physical therapy will begin on the first postoperative day.

Hoag’s physical therapy team will create a careful, well-planned rehabilitation program for you to follow, as physical therapy is critical to the success of your shoulder replacement. Most patients are able to perform simple activities such as eating, dressing and grooming within 2 weeks after surgery. Unrestricted, active use of your arm can begin as early as eight weeks after surgery.

About Reverse Total Shoulder Replacement

Reverse total shoulder replacement may be indicated for conditions that include completely torn, in operable, rotator cuffs and rotator cuff tears in association with arthritis, (a.k.a. cuff tear arthropathy.) In reverse total shoulder replacement, the socket and metal ball are switched. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to elevate the arm.

Hoag Orthopedic Hospital: Orthopedic Surgeons Specializing in Shoulder & Elbow Treatment

Shoulder replacement surgery is a highly technical procedure and is best performed by a surgical team that performs this surgery often. Hoag Orthopedic Institute is a single specialty service center for excellence in orthopedics. Here you will find that the surgical team has the expertise you need, from orthopedic surgeons who specialize in leading edge shoulder and elbow surgery, to orthopedic certified nurses and orthopedic dedicated surgical techs and physical therapists. Your surgeon will evaluate your situation carefully before making any decisions, and the surgical team will proceed with your safety, pain management, and the ultimate outcome for you in the forefront.


Find an Orthopedic Surgeon Specializing in Shoulder & Elbow Treatments.