Shoulder Replacement Surgery

The right procedure for you will depend on your age, level of activity, and the severity and type of your shoulder arthritis.

Total Shoulder Replacement Surgery
Your shoulder is a ball-and-socket joint. In this approach, the arthritic ball and socket are removed and replaced with a metal-and-plastic shoulder joint. Duke shoulder surgeons have extensive experience performing this procedure, which has been in use for more than 30 years. 

Total shoulder replacement can be performed with or without a stem that fits inside the humerus bone. If you have good bone density, a stemless total shoulder can often be used. 

Total shoulder replacement can be performed for osteoarthritis (the kind that develops due to wear and tear) or rheumatoid arthritis. You must have a normally functioning rotator cuff to have this surgery.

Partial Shoulder Replacement
People who want to continue very heavy lifting or who only have damage to one side of the joint may be candidates for this approach, which replaces only the ball of the joint.

Reverse Total Shoulder Replacement Surgery
If your rotator cuff is torn beyond repair and accompanied by arthritis, this may be your best option. In this approach, the ball and socket of the shoulder joint are reversed: A ball is attached where your shoulder socket normally sits, and a socket is fitted to the top of your upper arm bone. This allows you to use muscles other than the ones in the rotator cuff to move your arm.

Shoulder Revision Surgery
This may be recommended if you’ve had a previous shoulder replacement that failed, because of infection, or because the implant was incorrectly positioned or has become loose. Our shoulder surgeons' expertise in performing this procedure is well-known. People from across the country often come to Duke for help in correcting problems from reverse total shoulder replacements or failed rotator cuff repairs.

Is Shoulder Replacement Surgery an Outpatient Procedure?
In many cases, the surgery is performed on an outpatient basis, allowing patients to go home the same day after the surgery. However, some people stay overnight. Your surgeon will let you know what’s recommended for you.

How Long Does the Surgery Take?
The procedure can take one to two hours, depending on how complex it is.

How Painful Is Shoulder Replacement Surgery?
You shouldn’t feel any pain during the procedure. Before the surgery, the anesthesia doctor will use ultrasound to inject numbing medication around your nerves to provide a regional nerve block. The medication numbs the area from your neck down through your arm. The doctor may also give you a sedative to help you sleep through the procedure.

How Long Does Pain Last After Surgery?
The regional nerve block can be short- or long-acting and lasts 18 to 72 hours. You won’t feel much pain in the first couple of days after surgery. Your doctor will also recommend you start taking over-the-counter medications, which will keep your pain to a minimum as the nerve block wears off.

How Long Does It Take to Recover from a Shoulder Replacement?
How much time your recovery and rehab take will depend on several factors, including the type of surgery you have and how well you stick with physical therapy appointments and exercises. You’ll likely start physical therapy within a week after surgery. Over the next 16 weeks or so, you’ll gradually progress from assisted movement (your physical therapist or your good arm moving your affected shoulder) to light resistance exercises, to strengthening exercises. You may continue to gain strength up to a year or two following surgery. 

How Soon After Surgery Can I Return to Normal Activities?
In many cases, the affected shoulder can be used for midline activities of daily living like eating or dressing within the first week. “Midline activities” are ones where your elbow doesn’t go behind the midline of your body. You can start driving and performing light activities at home at six weeks.