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Total Shoulder Arthroplasty

What Is a Total Shoulder Arthroplasty?

Total shoulder arthroplasty—also called shoulder replacement—is a surgical procedure that replaces the damaged parts of the shoulder joint with artificial implants. It is designed to:

  • Relieve pain
  • Restore motion
  • Improve strength and function

The shoulder joint is a ball-and-socket joint made up of the humeral head (ball) and the glenoid (socket). When these structures wear out or are damaged, movement becomes painful and limited. These are the structures that are replaced.

Why Is Shoulder Arthroplasty Performed?

Your surgeon may recommend shoulder replacement if you have:

Severe Arthritis

Irreparable Massive Rotator Cuff Tears

Some massive and chronic rotator cuff tears lead to “cuff-tear arthropathy,” where the shoulder becomes weak, arthritic, painful, and unstable. This requires reverse shoulder arthroplasty.

Types of Shoulder Arthroplasty

1. Anatomic Total Shoulder Arthroplasty (aTSA)

This procedure recreates the natural anatomy of the shoulder:

  • Ametal ball replaces the humeral head
  • Aplastic liner replaces the socket

Best for:

  • Younger patients with healthy rotator cuff tendons

2. Reverse Total Shoulder Arthroplasty (rTSA)

In this design, the normal structure of the shoulder is “reversed”:

  • Ametal ball is placed on the shoulder blade side
  • Asocket is placed on the arm bone

This shifts the center of rotation and allows the deltoid muscle—instead of the rotator cuff—to lift the arm.

Best for:

  • Combined arthritis and rotator cuff disease
  • Complex revisions

Key point: Reverse TSA is chosen when the rotator cuff cannot do its job, allowing the deltoid to power the shoulder.

Recovery After Shoulder Arthroplasty

What to Expect After Surgery

Immediately After Surgery (Weeks 0–6)

  • Your arm will be in a sling most of the time.
  • You’ll begin gentle stretching directed by your therapist.
  • You can move your wrist, hand, and elbow freely.

Early Rehabilitation Phase (Weeks 6–12)

As healing progresses:

  • The sling is gradually discontinued
  • You begin active range-of-motion exercises
  • Lifting is still restricted (nothing heavier than a coffee cup)

 

Strengthening Phase (Months 3–6)

Once motion is safe and pain is controlled:

  • Progressive strengthening
  • Improve range of motion

Advanced Activity Phase (Months 6+)

  • Normalize range of motion
  • Return to desired recreational activities (e.g. Golf, Swimming, Tennis, Gym, etc)

Summary

Shoulder arthroplasty is an effective treatment for shoulder arthritis.

  • Anatomic TSArestores the natural anatomy and requires a functioning rotator cuff.
  • Reverse TSAallows the deltoid to lift the arm when the rotator cuff is damaged.

Most patients experience excellent pain relief and improved function with a structured recovery program, patience, and consistent therapy.

 

I hope this provides some useful information regarding the procedure and recovery. Please never hesitate to schedule a consultation with Dr. Huff if you think you may benefit from this procedure.

Best,

Scott Huff, MD