Shoulder Replacement

Shoulder replacement is the surgical procedure in which the damaged parts of the joint are replaced with implants. It is done to improve the functionality of the shoulder and to ease pain. Over 100,000 shoulder replacement surgeries are done in the United States every year, which makes it the third most common joint replacement, behind hip and knees.

Types of Shoulder Replacement

The two most common types are:

  • Primary Total Shoulder Replacement
  • Reverse Total Shoulder Replacement

Both of these replace the “total” shoulder joint, which means the implant completely replaces the damaged part of the “ball” and “socket.” The specific muscle groups used after surgery and the position of the implants mark the major differences between these two types.

What happens during shoulder replacement?

During a primary total shoulder replacement, the stem used has a smooth, rounded metal head, which replaces the “ball” of the shoulder joint. A smooth, rounded plastic cup is used to replace the “socket” and fit the metal head perfectly. Primary total shoulder replacement imitates the natural movement and anatomy of the shoulder. This might be recommended for those with advanced arthritis and a healthy rotator cuff.

During a reverse total shoulder replacement, the stem used has a curved, plastic tray, which replaces the “ball” of the shoulder joint. A rounded metal head that moves inside the plastic tray is used to replace the “socket.” The implants effectively reverse the ball and socket, which allows the stronger deltoid muscles to take over for function and strength. This is why it is called a Reverse. This might be recommended for those with:

  • Rotator cuffs that cannot be repaired or that are torn completely
  • Cuff tear arthropathy
  • Severe shoulder fracture
  • Large rotator cuff tear with a dislocated shoulder

What types of implants are used for shoulder replacement?

Your surgeon will evaluate your situation before selecting the implant that best meets your specific health needs, considering that there are different types of replacement implants available.

When is shoulder replacement recommended?

Shoulder replacement surgery might be recommended if you have been unable to get relief with the following tactics: rest, ice or moist heat, NSAIDs (nonsteroidal anti-inflammatories), physical therapy, and corticosteroid injections.