Shoulder Replacement Surgery: What You Need to Know About Anatomic and Reverse Total Shoulder Replacements

What Is Shoulder Replacement Surgery?

Shoulder replacement surgery, also called shoulder arthroplasty, involves removing damaged parts of the shoulder joint and replacing them with artificial components, typically made of metal and plastic. This procedure helps relieve pain and restore motion when non-surgical treatments (like physical therapy, injections, or medications) are no longer effective.

Common reasons for shoulder replacement include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Rotator cuff tear arthropathy
  • Severe fractures or trauma
  • Avascular necrosis

Types of Shoulder Replacement Surgery

There are two main types of shoulder replacement procedures: Anatomic Total Shoulder Replacement and Reverse Total Shoulder Replacement.

1. Anatomic Total Shoulder Replacement

Anatomic shoulder replacement, also known as conventional total shoulder replacement, is designed to mimic the natural anatomy of the shoulder. It involves:

  • Replacing the damaged humeral head (ball of the upper arm bone) with a metal ball.
  • Replacing the glenoid (socket of the shoulder blade) with a plastic socket.

This type of surgery is best suited for patients who:

  • Have intact rotator cuff tendons.
  • Suffer from arthritis or degenerative joint disease.
  • Have relatively stable shoulder anatomy.

Benefits of anatomic shoulder replacement:

  • Restores natural shoulder movement.
  • Long-lasting pain relief.
  • High patient satisfaction when rotator cuff is healthy.

2. Reverse Total Shoulder Replacement

Reverse total shoulder replacement is used when the rotator cuff is severely damaged or torn beyond repair. In this procedure:

  • The normal ball-and-socket structure is reversed.
  • A metal ball is attached to the shoulder blade (glenoid).
  • A plastic socket is placed at the top of the arm bone (humerus).

This “reversed” design allows the deltoid muscle (instead of the rotator cuff) to power the arm.

Reverse shoulder arthroplasty is ideal for patients with:

  • Irreparable rotator cuff tears (rotator cuff arthropathy).
  • Previous failed shoulder surgeries.
  • Complex fractures in older adults.

Advantages of reverse total shoulder replacement:

  • Provides stability and function even without a working rotator cuff.
  • Improves shoulder motion and reduces pain.
  • Excellent option for elderly or low-demand patients.

Recovery and Rehabilitation

Shoulder replacement recovery typically involves:

  • Hospital stay: 1–2 days
  • Immobilization: Sling worn for several weeks
  • Physical therapy: Begins soon after surgery to restore range of motion and strength
  • Full recovery: Usually takes 3–6 months

Adherence to post-operative instructions and physical therapy is crucial for a successful outcome.

Risks and Complications

While shoulder replacement surgery is generally safe and effective, like any surgery, it carries some risks:

  • Infection
  • Dislocation
  • Nerve damage
  • Loosening or wear of the implant
  • Blood clots

Choosing a skilled orthopedic surgeon and following recovery guidelines can help minimize these risks.

FAQs About Shoulder Replacement Surgery

Is shoulder replacement surgery painful?
You may experience some pain initially after surgery, but this is managed with medications. Most patients report significant pain relief after recovery.

How long do shoulder replacements last?
Modern shoulder implants typically last 15–20 years or longer with proper care.

Can you lift your arm after shoulder replacement?
Yes, most patients regain the ability to lift their arm. Range of motion depends on the type of replacement and the health of the surrounding muscles.

Which is better: anatomic or reverse shoulder replacement?
It depends on the condition of your shoulder, especially the rotator cuff. A surgeon will recommend the best option based on imaging and physical exam.

Final Thoughts

Shoulder replacement surgery can be life-changing, providing long-lasting pain relief and improved function. Whether you're a candidate for anatomic total shoulder replacement or reverse shoulder arthroplasty, consulting with an experienced orthopedic specialist is the first step toward regaining control of your life.

Shoulder Replacement Surgery: What You Need to Know About Anatomic and Reverse Total Shoulder Replacements

Shoulder replacement surgery is a highly effective treatment option for individuals suffering from chronic shoulder pain, arthritis, or severe fractures that limit mobility and reduce quality of life. This blog will explore the key differences between anatomic shoulder replacement and reverse total shoulder replacement, helping you understand which option might be right for you.

By
Dr. Sameh Elguizaoui, M.D.
,
on
June 25, 2025

What Is Shoulder Replacement Surgery?

Shoulder replacement surgery, also called shoulder arthroplasty, involves removing damaged parts of the shoulder joint and replacing them with artificial components, typically made of metal and plastic. This procedure helps relieve pain and restore motion when non-surgical treatments (like physical therapy, injections, or medications) are no longer effective.

Common reasons for shoulder replacement include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Rotator cuff tear arthropathy
  • Severe fractures or trauma
  • Avascular necrosis

Types of Shoulder Replacement Surgery

There are two main types of shoulder replacement procedures: Anatomic Total Shoulder Replacement and Reverse Total Shoulder Replacement.

1. Anatomic Total Shoulder Replacement

Anatomic shoulder replacement, also known as conventional total shoulder replacement, is designed to mimic the natural anatomy of the shoulder. It involves:

  • Replacing the damaged humeral head (ball of the upper arm bone) with a metal ball.
  • Replacing the glenoid (socket of the shoulder blade) with a plastic socket.

This type of surgery is best suited for patients who:

  • Have intact rotator cuff tendons.
  • Suffer from arthritis or degenerative joint disease.
  • Have relatively stable shoulder anatomy.

Benefits of anatomic shoulder replacement:

  • Restores natural shoulder movement.
  • Long-lasting pain relief.
  • High patient satisfaction when rotator cuff is healthy.

2. Reverse Total Shoulder Replacement

Reverse total shoulder replacement is used when the rotator cuff is severely damaged or torn beyond repair. In this procedure:

  • The normal ball-and-socket structure is reversed.
  • A metal ball is attached to the shoulder blade (glenoid).
  • A plastic socket is placed at the top of the arm bone (humerus).

This “reversed” design allows the deltoid muscle (instead of the rotator cuff) to power the arm.

Reverse shoulder arthroplasty is ideal for patients with:

  • Irreparable rotator cuff tears (rotator cuff arthropathy).
  • Previous failed shoulder surgeries.
  • Complex fractures in older adults.

Advantages of reverse total shoulder replacement:

  • Provides stability and function even without a working rotator cuff.
  • Improves shoulder motion and reduces pain.
  • Excellent option for elderly or low-demand patients.

Recovery and Rehabilitation

Shoulder replacement recovery typically involves:

  • Hospital stay: 1–2 days
  • Immobilization: Sling worn for several weeks
  • Physical therapy: Begins soon after surgery to restore range of motion and strength
  • Full recovery: Usually takes 3–6 months

Adherence to post-operative instructions and physical therapy is crucial for a successful outcome.

Risks and Complications

While shoulder replacement surgery is generally safe and effective, like any surgery, it carries some risks:

  • Infection
  • Dislocation
  • Nerve damage
  • Loosening or wear of the implant
  • Blood clots

Choosing a skilled orthopedic surgeon and following recovery guidelines can help minimize these risks.

FAQs About Shoulder Replacement Surgery

Is shoulder replacement surgery painful?
You may experience some pain initially after surgery, but this is managed with medications. Most patients report significant pain relief after recovery.

How long do shoulder replacements last?
Modern shoulder implants typically last 15–20 years or longer with proper care.

Can you lift your arm after shoulder replacement?
Yes, most patients regain the ability to lift their arm. Range of motion depends on the type of replacement and the health of the surrounding muscles.

Which is better: anatomic or reverse shoulder replacement?
It depends on the condition of your shoulder, especially the rotator cuff. A surgeon will recommend the best option based on imaging and physical exam.

Final Thoughts

Shoulder replacement surgery can be life-changing, providing long-lasting pain relief and improved function. Whether you're a candidate for anatomic total shoulder replacement or reverse shoulder arthroplasty, consulting with an experienced orthopedic specialist is the first step toward regaining control of your life.