Shoulder arthroplasty (shoulder replacement) is used to treat severe shoulder arthritis, complex fractures, or rotator cuff-deficient shoulders that no longer respond to non-surgical treatment. Depending on the pattern of damage, this may involve anatomic total shoulder replacement or reverse shoulder arthroplasty.
What is Shoulder Arthroplasty?
Shoulder arthroplasty involves resurfacing or replacing the damaged ball-and-socket joint of the shoulder with an artificial implant, relieving pain and restoring movement once the joint surfaces are too worn or damaged to repair. It is most commonly performed for advanced osteoarthritis, post-traumatic arthritis, avascular necrosis, or severe fracture of the proximal humerus.
Anatomic vs Reverse Shoulder Arthroplasty
In anatomic total shoulder replacement, the ball-and-socket relationship of the joint is preserved, replacing the humeral head and glenoid in their normal orientation; this relies on an intact, functioning rotator cuff. Reverse shoulder arthroplasty reverses the ball-and-socket relationship, placing the ball on the glenoid (socket) side and the socket on the humeral side. This design allows the deltoid muscle to compensate for a deficient or torn rotator cuff, making it the preferred option for patients with cuff-tear arthropathy, irreparable rotator cuff tears, complex fractures, or failed previous shoulder replacement.
Symptoms Suggesting You May Need Shoulder Replacement
- Persistent deep shoulder pain, including at rest or at night
- Progressive stiffness and loss of range of motion
- Weakness or inability to raise the arm, particularly with large rotator cuff tears
- Reduced quality of life and function despite physiotherapy, injections and other non-surgical treatment
Diagnosis
Diagnosis is based on clinical assessment of pain, range of motion and rotator cuff function, together with X-rays to assess joint wear and bone stock, and often a CT or MRI scan to evaluate glenoid bone loss, rotator cuff integrity and plan implant positioning.
Computer Navigation, Augmented Reality and Robotic-Assisted Shoulder Arthroplasty
Modern shoulder arthroplasty increasingly uses pre-operative 3D CT planning together with computer navigation, augmented reality and robotic-assisted guidance to improve the accuracy of glenoid implant positioning, which is a key factor in implant longevity and outcomes, particularly in patients with complex bone loss or deformity. Dr Guo trained in these techniques during his fellowship in shoulder arthroplasty at the Centre Orthopedique Santy in Lyon, France, under Dr Lionel Neyton, a leading authority on navigated and robotic-assisted shoulder replacement.
Recovery
Recovery after shoulder arthroplasty involves an initial period of sling protection followed by a structured, progressive rehabilitation programme to restore motion and strength, with most patients returning to daily activities over several months. Please see our Rehabilitation Protocols section for general post-operative guidelines.
This article is intended for general information only and does not replace a personal consultation. If you are experiencing shoulder pain or stiffness affecting your daily activities, please arrange an appointment for an individual assessment.