Overview
Total Shoulder Replacement, also called Anatomic Total Shoulder Arthroplasty (TSA), is a surgical procedure designed to relieve shoulder pain and improve movement in people with shoulder arthritis. It is especially effective for individuals with osteoarthritis who still have a healthy rotator cuff—the group of muscles and tendons that stabilize and move the shoulder.
This procedure restores normal shoulder anatomy by replacing the damaged ball-and-socket joint with artificial parts that mimic the natural shape and function of the shoulder.
Why Total Shoulder Replacement?
Many patients with arthritis of the shoulder suffer from pain, stiffness, and reduced ability to carry out daily activities like reaching overhead, dressing, or lifting objects. If nonsurgical treatments such as medications, physical therapy, or injections have failed to provide relief, shoulder replacement may offer a long-term solution.
Anatomic TSA is ideal for patients who:
- Have advanced glenohumeral osteoarthritis (wear-and-tear arthritis in the main shoulder joint)
- Still have an intact and functioning rotator cuff
- Wish to regain shoulder function and reduce or eliminate chronic pain
What Happens During Surgery?
In an anatomic total shoulder replacement:
- The surgeon removes the damaged surface of the humeral head (the ball of the upper arm bone) and replaces it with a metal implant.
- The worn-out surface of the glenoid (the shoulder socket) is resurfaced with a smooth plastic component.
- The new components work together to create a stable, smooth-moving shoulder joint.
The procedure is typically performed through an incision in the front of the shoulder, and the rotator cuff is carefully protected and repaired if needed.
What to Expect After Surgery
After surgery, patients wear a sling or immobilizer for a period of time to protect the shoulder while it heals. Physical therapy is a key part of recovery and begins shortly after surgery, helping patients gradually regain movement and strength.
Most patients experience:
- Significant relief from shoulder pain
- Improved ability to raise the arm and perform daily activities
- Better sleep, especially if pain was keeping them awake at night
Full recovery takes time, but steady progress is expected with proper rehabilitation and guidance.
How Is This Different From Reverse Shoulder Replacement?
In Reverse Shoulder Replacement, the position of the ball and socket is reversed. This type of surgery is usually reserved for people who have large, irreparable rotator cuff tears or complex shoulder problems where the rotator cuff no longer works.
Anatomic TSA, by contrast:
- Keeps the natural shape and orientation of the joint
- Is better suited for patients who have healthy rotator cuffs
- Tends to offer more natural movement, particularly for tasks like reaching behind the back or to the side
Choosing the right procedure depends on your shoulder condition and the integrity of your rotator cuff. A thorough evaluation will help determine which surgery is best for you.
Who Should Consider This Surgery?
This procedure is often recommended for patients who:
- Have persistent shoulder pain that interferes with daily life
- Have not responded to other treatments
- Are looking for a long-term solution that restores function
- Still have a working rotator cuff
Age alone should not be the deciding factor in choosing a type of shoulder replacement. Many older adults do very well with anatomic total shoulder replacement when properly selected.
Benefits of Total Shoulder Replacement
- Pain Relief: The most common and reliable benefit. Most patients experience a dramatic improvement in comfort.
- Improved Mobility: Easier movement and ability to lift, reach, and perform daily tasks.
- Restoration of Function: Better arm control for dressing, grooming, cooking, and other normal routines.
- Long-Lasting Results: Modern implants and surgical techniques are designed to provide durable performance over many years.
Conclusion
If you are living with shoulder arthritis and still have a functional rotator cuff, Total Shoulder Replacement may be the best option to restore your quality of life. It offers a safe, effective, and proven way to regain comfort and motion in your shoulder.
Consult with your orthopedic surgeon to see if this approach is right for your individual needs and health goals.
