Educational video describing total shoulder replacement surgery.

Why is a shoulder joint replacement done?

Total shoulder joint replacement is an option given to patients who suffer from joint dysfunction. This is usually the result of osteoarthritis or rheumatoid arthritis, but more rarely for those who have sustained severe trauma from a shoulder fracture. Generally, all other modes of treatment are considered first, such as physical therapy and medication, but total shoulder replacement can provide pain relief and increased mobility for those who have not experienced relief.

This document presents a general overview of total shoulder replacement surgery at Cleveland Clinic. Because each patient's condition differs, please take note that certain aspects of your care may be altered according to your needs and the recommendations of your orthopaedic surgeon.

The shoulder anatomy

Similar to the hip joint, the shoulder is a large ball and socket joint. It is made up of bones, tendons, muscles, and ligaments, which hold the shoulder in place but also allow movement. Bones of the shoulder joint include: the clavicle (collar bone), scapula (shoulder blade), and humerus (arm bone). The clavicle attaches the shoulder to the rib cage and holds it out away from the body.

The clavicle connects with the large flat triangular bone, the scapula (shoulder blade) at the acromioclavicular joint (A.C. joint or the acromion). The rounded head of the humerus, or arm bone, rests against the socket in the shoulder blade.

In a total shoulder replacement, a metal ball is used to replace the humeral head while a polyethylene cup becomes the replacement of the glenoid socket.

The primary indication for a total shoulder replacement is pain which will not respond to non-operative treatment. Pain may be the result of abnormalities and changes in the joint surfaces as a result of arthritis or fractures.

The primary goal of total shoulder replacement surgery is to alleviate pain with secondary goals of improving motion, strength and function.

Consultation visit

Your consultation visit and initial appointment with the orthopaedic surgeon will include a series of X-rays, a physical examination, and a thorough review of your medical history.

  • X-rays can usually reveal bone spurs, damaged joint surfaces and any narrowed joint spaces. The physical exam will help determine the source of pain with motion and also the decrease in range of motion.
  • Detailing a history of your shoulder problem includes describing for the surgeon the degree of pain with activity, limited use, loss of motion and pain at rest, if any.
  • You, your surgeon and your family are all active participants in selecting the most appropriate treatment.