Short answer
Shoulder replacement replaces the damaged ball, and often the socket, of the shoulder joint with artificial parts. It is usually done for severe pain or loss of movement from arthritis, a large rotator cuff tear or a bad fracture when other treatment has not helped. The operation takes about two hours, the arm is then kept in a sling for several weeks, and rehabilitation continues for months. The type of replacement chosen depends mainly on the cause of the damage and whether the rotator cuff tendons still work.
Key points
- There are four main types: total, reverse total, stemmed partial and resurfacing.
- A reverse replacement is used when the rotator cuff is badly torn and cannot be repaired.
- Most people use a sling for about 2 to 6 weeks and avoid driving for a similar period.
- Strengthening exercises usually begin around three months after surgery.
- More than 9 in 10 shoulder replacements are still working at 10 years.
Why shoulder replacement is done
The shoulder is a ball-and-socket joint: the head of the humerus (upper arm bone) sits in a shallow socket called the glenoid. Shoulder replacement may be considered when damage to this joint causes severe pain that limits daily activities or sleep, loss of movement or weakness, and medicines, injections or physiotherapy have not helped enough.1
The usual causes are:1
- Osteoarthritis: age-related wear of the joint cartilage, a common reason for surgery.
- Rheumatoid arthritis: long-term inflammation of the joint lining that damages cartilage.
- Post-traumatic arthritis: arthritis that follows a fracture, dislocation or tendon injury.
- Avascular necrosis: loss of blood supply to the bone, which can lead to collapse and arthritis.
- Rotator cuff tear arthropathy: joint destruction after a large, long-standing tear of the rotator cuff (the tendons that hold the ball in the socket).
- Severe fractures, often in older people with osteoporosis, and failed earlier replacements.
The main types of shoulder replacement
The choice depends on which part of the joint is damaged and, crucially, whether the rotator cuff still works.1
| Type | What is replaced | Typically used for |
|---|---|---|
| Total (anatomic) shoulder replacement | Ball replaced with metal, socket with plastic | Bone-on-bone osteoarthritis with an intact rotator cuff |
| Reverse total shoulder replacement | Ball and socket swapped, so the deltoid muscle rather than the cuff lifts the arm | Large unrepairable cuff tears, cuff tear arthropathy, some fractures, failed previous replacements |
| Stemmed hemiarthroplasty (partial) | Ball only, fixed with a stem in the arm bone | Severe fractures of the ball with a normal socket, or a socket too damaged to replace |
| Resurfacing hemiarthroplasty | Ball capped without a stem | Younger or active people with a healthy socket who want to preserve bone |
For osteoarthritis, studies show better pain relief from a total replacement than from replacing the ball alone.1 A total anatomic replacement is generally not advised if the rotator cuff cannot be repaired, which is the main situation for a reverse design.1
What happens during the operation
The anaesthetic may be general, regional or a combination.1 One NHS specialist centre describes its usual approach as a general anaesthetic combined with a nerve block (an injection that numbs the arm), which limits pain after surgery while you breathe unaided.2
Surgery usually takes about two hours.1 Some people go home the same day, and most who stay in go home the next day; people with conditions such as heart disease or diabetes, or little support at home, may need longer.1 The same NHS centre typically keeps patients for one to two nights and takes a check X-ray on the day of surgery or the day after.2
What recovery involves
Recovery is gradual and depends on the operation and the surgeon’s protocol. Gentle physiotherapy starts soon after surgery, and most people can eat, dress and groom themselves within about two weeks. Some pain with activity and at night is common for several weeks.1
- Sling: about 2 to 6 weeks.1 One NHS centre uses about 3 weeks, followed by 3 more weeks of restricted movement.2
- Early limits: no lifting heavier than a glass of water for 2 to 6 weeks, no pushing up from a bed or chair with the arm, and no extreme positions out to the side or behind the body for 6 weeks.1
- Driving: usually avoided for 2 to 6 weeks.1
- Exercises: home exercises two to three times a day for a month or more; at the NHS centre, structured range-of-motion work begins at around 8 weeks and strengthening at around 3 months.12
Even after full recovery, contact sports and repetitive heavy lifting are generally advised against.1
Risks and how long it lasts
Recognised complications include infection (which can occur even years later), wear, loosening or dislocation of the implant, fractures of the surrounding bone and, less often, nerve damage that frequently improves.1 One NHS centre gives these figures for its patients:2
| Risk | Quoted figure |
|---|---|
| Symptoms not relieved | Less than 10% |
| Dislocation | 5% |
| Infection | 2.5% |
| Stiffness (frozen shoulder) | 1 in 100 |
| Blood clots in the leg or lung | Less than 0.5% |
| Loosening needing further surgery | 0.3% |
| Nerve damage | Less than 1 in 1,000 |
On durability, a 2020 systematic review and meta-analysis in The Lancet Rheumatology, covering nearly 18,000 people, found that more than 90% of shoulder replacements were still working at 10 years.3 Ten-year survival was 92% to 95% for total replacements, 94% for reverse replacements and 86% to 90% for partial replacements.4 The authors noted a lack of follow-up beyond 10 years, so the evidence on longer-term survival is Limited.4
Common questions
Is a reverse shoulder replacement worse than a normal one?
No; it is designed for a different problem. It lets the deltoid muscle lift the arm when the rotator cuff no longer can.1 In the 2020 review its 10-year survival was similar to that of a total anatomic replacement.4
How long will I need a sling?
Usually between 2 and 6 weeks, depending on how complex the surgery was and on the surgeon’s preference.1
Will I sleep badly afterwards?
Possibly for a while: some pain at night is common for several weeks after surgery.1
Can I go back to sport afterwards?
Not to every sport: contact sports and repetitive heavy lifting are generally advised against even after full recovery.1 For preparation before any joint operation, see whether exercise before joint replacement helps.
Bottom line
Shoulder replacement is a major operation with a long rehabilitation, chosen when shoulder damage causes severe pain or disability despite other treatment. Which design is suitable depends on the cause and the state of the rotator cuff, and most implants still function at 10 years.
Related reading
- Orthopaedics overview
- How long do knee and hip replacements last?
- Does exercise before joint replacement help?
- What is hip resurfacing?
- How soon can you fly after surgery?
Sources
- American Academy of Orthopaedic Surgeons. Shoulder joint replacement. OrthoInfo. https://www.orthoinfo.org/treatment/shoulder-joint-replacement/. Accessed 5 November 2026.
- Elective Orthopaedic Centre (NHS). Shoulder replacement. https://www.eoc.nhs.uk/treatments/shoulder-replacement/. Accessed 5 November 2026.
- NIHR Bristol Biomedical Research Centre. Shoulder replacements benefit most patients for more than 10 years, study shows (reporting Evans JP, et al. How long does a shoulder replacement last? A systematic review and meta-analysis. The Lancet Rheumatology; 2020). 2020. https://www.bristolbrc.nihr.ac.uk/news/shoulder-replacements-benefit-most-patients-for-more-than-10-years-study-shows. Accessed 5 November 2026.
- National Institute for Health and Care Research. Most shoulder replacements last longer than a decade: research reassures patients. NIHR Evidence; 2021. doi:10.3310/alert_46075. https://evidence.nihr.ac.uk/alert/most-shoulder-replacements-last-longer-than-a-decade-research-reassures-patients. Accessed 5 November 2026.
Article history
- — First published.