Total shoulder replacement, also known as total shoulder arthroplasty (TSA), is a tremendously successful procedure for treating the severe pain and stiffness that often result at the end stage of various forms of arthritis or degenerative joint disease of the shoulder joint.

The primary goal of shoulder replacement surgery is pain relief, with a secondary benefit of restoring motion, strength, and function.

Doctors recommend joint replacement surgery when shoulder pain and loss of function become severe and when medicines and other treatments no longer relieve pain.

The surgery involves replacing the humeral head (or joint “ball”) and the glenoid (called the “socket”).

Anatomy of the shoulder area, depicting the implant
after surgery. Partial shoulder replacement (or hemi-replacement) may also be indicated with certain severe shoulder fractures of the humeral head. This technique requires the replacement of that component only.

  1. Either regional anesthesia with interscalene block or general anesthesia is used for total shoulder replacement arthroplasty. During the operation, the patient will be sedated and unconscious, positioned in a “beach-chair” position.
  2. There are many different types of implants that are used for shoulder replacement. They all, however, share the same basic components: a metal ball that rests against a plastic (polyethylene) socket. The goal of shoulder replacement is to remove the patient’s arthritic humeral head, replace it with the metal “ball” component with a stem that extends down inside the patient’s humerus (upper arm bone), and then place a plastic socket over the surface of the patient’s own glenoid.
  3. The surgeon begins by separating the deltoid and pectoral muscles, accessing the shoulder in a largely nerve-free area to minimize nerve damage. The shoulder is covered by the rotator cuff, which must be opened by cutting one of the anterior (front) rotator cuff muscles. This “opens the door,” allowing the surgeon to view and manipulate the arthritic sections of the shoulder.
  4. After the arthritic sections have been removed, the surgeon inserts the implant socket, ball, and stem components; closes and stitches the rotator cuff muscle; and stitches and cleans the incision.


  1. Shoulder Stiffness
  2. Instability
  3. Infection
  4. Nerve Damage
  5. Glenoid Loosening


  1. Reduces pain.
  2. Restore mobility in patients with end stage shoulder arthritis, and occasionally after certain severe shoulder fractures.

Shoulder problems treated with Arthroscopy