Shoulder replacement

Your health expert: Mr Michael Walton, Orthopaedic Shoulder Surgeon
Content editor review by Rachael Mayfield-Blake, Freelance Health Editor, September 2023
Next review due September 2026

Shoulder replacement surgery is an operation to replace your damaged shoulder joint with an artificial joint. You can have a total or partial shoulder replacement. You may be offered this surgery because of wear and tear, usually from arthritis or an injury.

About shoulder replacement

Your shoulder is a ball-and-socket joint. The ball at the top of your upper arm moves smoothly in the socket of your shoulder blade on a lining of cartilage (a type of strong tissue). The cartilage prevents your bones from rubbing together. Any damage to the cartilage from an injury or arthritis can make your joint painful and stiff.

A new shoulder joint can help to improve your shoulder movement and reduce pain. Artificial shoulder parts are usually made of metal or plastic, or a combination of the two.

Most people who have shoulder replacement surgery are between 65 and 84, but both older and younger people have it too. An artificial shoulder joint will usually last for at least 10 years, often for much longer.

Types of shoulder replacement

There are several different types of shoulder replacement surgery. Your surgeon will talk through which is the best procedure for you. This will depend on:

the condition of the muscles around your shoulder
the stability of your shoulder
the strength of your bones

The four main types of shoulder replacement procedure are described below.

Reverse shoulder replacement

Reverse shoulder replacement surgery is the most common shoulder replacement procedure. It gets its name from the fact that your surgeon will switch round the positions of the ball and socket in your joint. They’ll attach a metal ball to your shoulder blade, where your socket was before. And they’ll attach a new socket to the top of your upper arm, where the ball was. The new ball and socket will be fixed firmly in place with bone cement.

A reverse shoulder replacement is used when your muscles no longer work properly, for example if you have a rotator cuff tear.

Total shoulder replacement

This is the second most common type of shoulder replacement procedure. If you have this type of operation, your surgeon will replace the ball at the top of your upper arm with a new metal ball. They’ll also replace the socket in your shoulder blade with a new plastic socket. As with the reverse replacement, the new ball and socket are fixed in place with bone cement.

Not everybody can have this operation. The muscles around your shoulder will need to function well for it to work.

Partial shoulder replacement (hemiarthroplasty)

In a partial shoulder replacement, your surgeon will only replace the ball at the top of your arm. The new metal ball will then move within the socket you already have.

Resurfacing shoulder replacement

This means replacing only the worn surfaces of the shoulder joint. In partial resurfacing, your surgeon will remove the damaged surface of the ball and place a cap over it.

Revision surgery

A repeat shoulder replacement operation is known as a revision. You may need this if your implant becomes loose or wears out.

Revision surgery can be more complicated than your first operation. Your surgeon will need to remove your artificial joint before they can put in a new one. And they’ll need to remove more of the bone of your upper arm in a second operation, which can make it more likely to break (fracture). It usually takes a little longer to recover from a repeat shoulder replacement than from the first operation and the complications (especially the risk of infection) are higher.

Talk to your surgeon if you’d like more information about revision surgery.

Preparation for a shoulder replacement

Most hospitals will invite you for a pre-admission visit a week or so before your shoulder replacement surgery. They’ll check that you’re fit for your operation and anaesthetic and tell you how to prepare for your procedure. If you have any questions, it’s a good opportunity to ask them.

Before you go into hospital, think about how you’re going to get to and from hospital and manage at home afterwards. Make sure someone can take you to the hospital and bring you home after your operation. Plan to be away from home for around two to three days. Sometimes it’s possible to have the operation and go home the same day, or after one night in hospital.

Once you go home, you might want someone to stay with you to help out for a while.

In hospital

If you're having a general anaesthetic, you won’t be able to eat or drink for a time beforehand (usually six hours). Your surgeon or anaesthetist will tell you exactly how long. It’s important to follow their advice.

Your surgeon will describe what will happen before, during and after your shoulder replacement surgery. Once you understand the procedure, and if you agree to have it, your doctor will ask you to sign a consent form.

Shoulder replacement procedure

An orthopaedic surgeon will do your shoulder replacement – this is a doctor who specialises in bone surgery.

You’ll usually have a shoulder replacement surgery with a combination of a general anaesthetic and regional anaesthetic. A general anaesthetic means you’ll be asleep during the operation. A regional anaesthetic completely blocks pain from your shoulder. Your anaesthetist will talk to you about which type of anaesthesia is best for you.

Your surgeon will make a cut to reach your shoulder joint, usually down the front but it may be at the side of your shoulder. At the end of the operation, your surgeon will close the cut with stitches and cover the wound with a dressing.

Aftercare following a shoulder replacement

You’ll usually need to stay in hospital for around two to three days after shoulder replacement surgery.

If you have a regional anaesthetic, it may take several hours before you get feeling back in your shoulder. You’ll have pain relief to help with any discomfort. You may have injections, tablets, or patient-controlled analgesia (PCA) through a drip. With PCA, you have a button to press when you need more pain relief.

You may need to wear elastic stockings and have injections of anti-clotting medicine after your surgery. This will help prevent blood clots (deep vein thrombosis).

You may have fine tubes running out from your wound. These drain fluid into a bag and will usually be removed after a day or two.

A physiotherapist will visit you after your operation to guide you through exercises and ways to move your shoulder to help you recover. You’ll probably start these the day or day after your operation. These will help to prevent stiffness and your shoulder to heal. It’s very important to follow their advice about how to move your shoulder.

You may have an X-ray of your new joint while you’re in hospital.

Your nurse should give you some advice about caring for your healing wounds before you go home, and give you a date for a follow-up appointment.

Having a general anaesthetic can affect your co-ordination and make it difficult to think clearly. Don’t drink alcohol or operate machinery for 24 hours after your anaesthetic, or sign any important documents until you’ve recovered. You won’t be able to drive for a while after your shoulder operation – ask your surgeon how long.

Recovery following a shoulder replacement

Shoulder replacement recovery time can vary but it usually takes at least three to six months to make a full recovery from shoulder replacement surgery. But you should be able to lift your arm to get dressed, cook and wash yourself after about six weeks.

You’ll go home from hospital with a sling to support your arm and shoulder. For up to six weeks after the operation, you will need to wear it all the time, including at night. Your surgeon or physiotherapist will give you more advice about when to wear it.

Your physio will give you an exercise plan to get your shoulder joint moving and help your recovery. These exercises will also help to strengthen the muscles around your shoulder. It’s important to do the exercises for as long as your physiotherapist recommends.

Your physio will also tell you about some movements you shouldn’t do, such as put your arm behind your back. Take care not to use your arm to push yourself up out of bed or a chair too.

Your surgeon may tell you not to lift anything heavier than a cup of tea for six weeks after your operation. Don’t do any heavy lifting or play any contact sports for at least six months.

Ask your surgeon for advice about going back to work and other activities, such as driving. How quickly you can drive again will depend on how well you recover. You’ll need to contact your motor insurer before you drive.

Your hospital will usually give you painkillers to take home when you leave hospital. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist. If you have severe pain or it doesn’t get better, contact your surgeon for advice.

Side-effects of a shoulder replacement

Side-effects are unwanted effects you may have from any medical treatment. After shoulder replacement surgery you may have:

discomfort or pain in your shoulder
some difficulty moving your shoulder due to pain and weakness
numbness around your scar
swelling of your fingers

These side-effects are usually temporary and should gradually settle over four to six weeks.

Complications of a shoulder replacement

Complications are when problems occur during or after the operation. These complications don’t happen very often, but it’s good to be aware of them.

Complications of shoulder replacement surgery include the following.

Infection of the wound or joint. Your surgeon may give you antibiotics around the time of surgery to help prevent this.
A break (fracture) of your upper arm bone, either during, or after the operation.
Damage to nerves, muscles and blood vessels around your shoulder. Over time, some nerve injuries may get better and some even recover completely.

Possible longer-term complications, include:

instability of your shoulder joint, which may even move out of its socket (dislocate)
loosening of the replacement parts, especially the new ‘socket’ part in the shoulder

You may have to have a further operation on your shoulder if you develop complications. Ask your surgeon for more information about complications.

Sepsis (adults)

Sepsis is a life-threatening complication that can develop if you get an infection – it’s a medical emergency. Call 999 or go to A&E immediately if you have any of the following symptoms.

A high temperature or fever.
Redness and swelling around your shoulder.
Slurred speech, confusion, difficulty making sense.
Extreme shivering or muscle pain.
Passing no pee (urine) during a day.
Severe difficulty breathing, feeling breathless, or breathing very fast.
Feeling like you’re going to die.
Skin changes, such as your skin looking blue, pale or blotchy, or a rash that doesn’t fade when you roll a glass over it.

Alternatives to shoulder replacement

Surgeons usually only recommend shoulder replacement surgery if other treatments haven’t worked. These may include:

physiotherapy
non-steroidal anti-inflammatory medicines
medicines for arthritis
steroid joint injections
local anaesthetic injections to relieve pain
shoulder arthroscopy (keyhole surgery) to clean out the joint or remove any areas of inflamed joint lining

These are part of the range of treatments for osteoarthritis and rheumatoid arthritis.

If your surgeon thinks surgery is the best option for you, they’ll explain why.

Looking for physiotherapy?

You can access a range of treatments on a pay as you go basis, including physiotherapy.

To book or to make an enquiry, call us on 0370 218 6528^∧

Find out more about physiotherapy

It’s natural to have pain after an operation. But everyone is different so it’s not possible to say exactly how you’ll feel. You’ll be given painkillers straight after your operation. You’ll usually have some to take home too.

See our aftercare following a shoulder replacement and recovery following a shoulder replacement sections for more information.

It usually takes around three to six months to make a full recovery from shoulder replacement surgery. But you should be able to lift your arm to get dressed, cook and wash yourself after about six weeks. You might find your shoulder function continues to get better for up to a year.

See our recovering from shoulder replacement section for more information.

Shoulder replacement is generally very successful, with implants lasting 10 years or more. As with any joint replacement, the implant can loosen or wear out over time. If this happens, you’ll need to have another operation (revision surgery).

See our types of shoulder replacement section for more information.

Yes, shoulder replacement is major surgery. You may need to have a general anaesthetic and it can take months to recover. There are also potential complications to consider. These include breaking your upper arm bone, as well as damage to nerves, muscles and blood vessels around your shoulder. There are alternatives to shoulder replacement surgery but if your surgeon thinks surgery is the best option for you, they’ll explain why.

See our complications of a shoulder replacement and alternatives to shoulder replacement sections for more information.

Other helpful websites

Versus Arthritis

Discover other helpful health information websites.

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