Anatomic Total Shoulder Replacement
What Is a Total Shoulder Replacement?
An anatomic total shoulder replacement resurfaces the shoulder joint using the body's normal ball-and-socket arrangement — a smooth metal ball replaces the arthritic head of the arm bone, and a plastic socket replaces the damaged joint surface on the shoulder blade. It's the standard replacement option for patients with shoulder arthritis who still have a healthy, functioning rotator cuff.
When This Approach Makes Sense
Anatomic replacement depends on an intact rotator cuff, since the cuff is what moves the joint after surgery — this is the key factor that separates it from a reverse replacement. It's typically recommended for patients with osteoarthritis or another form of shoulder arthritis causing pain and stiffness, who have preserved rotator cuff function and haven't responded adequately to nonsurgical treatment.
Diagnosis and Deciding on Surgery
Diagnosis combines a physical exam with imaging — X-rays typically show joint space narrowing and bone changes characteristic of arthritis, and additional imaging (like MRI) can confirm the rotator cuff is intact before committing to the anatomic approach rather than a reverse replacement.
Nonsurgical Options
Before considering replacement, many patients try activity modification, physical therapy, anti-inflammatory medication, and corticosteroid injections. Surgery is generally considered once these measures no longer provide adequate relief and arthritis is significantly limiting daily function.
Frequently Asked Questions:
What's the difference between anatomic and reverse shoulder replacement?
Anatomic replacement preserves the shoulder's normal ball-and-socket arrangement and requires a healthy rotator cuff to function well. Reverse replacement changes that geometry so the deltoid muscle can move the arm instead, and is used when the rotator cuff is too damaged to rely on.
How do I know if I need a shoulder replacement?
Persistent shoulder pain and stiffness from arthritis that hasn't improved with therapy, medication, or injections is the usual indication — imaging confirms the degree of joint damage and helps determine which type of replacement is appropriate.
How long does a shoulder replacement last?
Most shoulder replacements provide many years (decades) of reliable function, though the exact lifespan depends on factors like activity level and bone quality, and is best discussed individually.