Total Shoulder Replacement

The primary reason for a shoulder replacement is arthritis. Unfortunately, when arthritis restricts function, and makes daily activity difficult and painful, and medications and physical therapy fail to improve your pain, surgery is the only option. Total replacement is also indicated when trauma destroys the joint.

About 53,000 Americans have a shoulder replacement each year. Clinical studies have shown that shoulder replacement surgery is effective to relieve pain, improve mobility and restore independence.

The key to success with any surgical method is dependent on the overall health of the joint, a skilled, experienced orthopedic surgeon like those at Orthopaedic Specialists of North County (OSNC); using state-of-the-art techniques and technology; and rehabilitation with board-certified, compassionate, caring physical therapists.

Traditional Total Shoulder Replacement

When there is damage to the joint caused by arthritis or trauma, the old ball and socket is replaced with implants. A new high-impact plastic socket and a metal ball that is fixed to the upper arm bone(humerus). However, if a patient has arthritis and a damaged rotator cuff, your surgeon at OSNC may discuss reverse total shoulder replacement surgery as an option. The success of traditional total shoulder replacement surgery depends on the health of the rotator cuff.

Indications for this surgery:

  • Shoulder arthritis or trauma that severely damages the joint
  • No rotator cuff tears
  • Men and women over the age of 50

Risks and Complications

These vary between people depending on their health. Generally, risks include:

  • Infection
  • Instability
  • Rotator cuff injury/detachment of the muscles
  • Fractures of the joint
  • Blood clots
  • Dislocation
  • Nerve damage

After anesthesia wears off, it may take a few hours before you regain feeling in your shoulder and arm. You will go home wearing a sling to immobilize the new joint. And you will have limits on activities while you are healing.


Going home you will need help, so plan ahead to arrange for after care, and follow up visits. You and your orthopedic surgeon will discuss a rehabilitation plan before surgery, which you are expected to follow to achieve complete healing and restoration of function. It is important to have pain control so you can participate in rehabilitation, and keep follow up appointments.

It may take 6-12 months to fully recover. The usual outcome is significant pain relief with improved function and range of motion. The implants have a life span that will last about 10-20 years before they will require replacement.

Reverse Total Shoulder Replacement

Reverse total shoulder replacement is similar to conventional total replacement surgery because it also replaces the ball and socket joint with implants. The difference is that the replacement ball is attached to the shoulder bone and the socket is attached to the upper arm bone. This surgery is used primarily for people with:

  • Large rotator cuff tears
  • A significant rotator cuff tear coupled with severe arthritis
  • those who have previously had a shoulder replacement,
  • serious fractures of the arm bone and

The usual outcome is significant pain relief and improved function and range of motion. The implants used in this approach last about 10 years, before requiring replacement.

The benefit of the reverse approach is that it allows the muscle to supply movement to the arm, instead of the torn rotator cuff. The use of a muscle takes the burden off of the rotator cuff. With this approach, more than 90% of patients find significant pain relief and improved function.

Which is the Best Option?

Your Surgeon, at Orthopaedic Specialists of North County, will conduct an orthopedic evaluation. Then your surgeon will carefully review with you, your specific situation and the results of imaging tests. The two of you will discuss which type of replacement is the best option for you.

The board-certified orthopedic surgeons at OSNC have served patients in Greater San Diego County including Oceanside, Vista, San Marcos, Escondido, Carlsbad, Encinitas, and Solana Beach, California since 1973. We never stop learning new techniques and invest in the most advanced technologies to provide you with quality care from a compassionate team who will help you understand your options so you can make an informed choice, and treat you with respect.

"The entire team at OSNC is great, very professional and took the time to put me at ease. And I only have praise for the Dr. Erik Stark, a wonderful doctor who never disappoints!" Patient of Dr. Erik Stark
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