What it is
Shoulder arthroplasty replaces damaged joint surfaces. Anatomic total shoulder replacement preserves the native geometry of the intact rotator cuff. Reverse shoulder replacement changes the joint orientation to improve deltoid leverage when the cuff is deficient.
Goals are pain relief and reliable motion for daily tasks. Rehabilitation helps restore range of motion, strength, and confidence.
What happens when it occurs
Implants resurface the joint. Hospital protocols begin with early mobility and safe transfers. The plan progresses from protected motion to strength and functional training. Reverse replacements follow additional precautions early.
Common causes and risk factors
- End-stage osteoarthritis or cuff tear arthropathy
- Post-traumatic arthritis
- Failed prior surgery
Who is most affected
Older adults with persistent pain and functional limitation despite non-surgical care.
Typical symptoms pre op
- Deep aching shoulder pain with stiffness
- Sleep disturbance
- Loss of reach and lifting capacity
When to seek care
When pain and function remain limited despite a clear conservative programme.
How we diagnose
History, examination, and X-rays. CT and MRI are used for planning in selected cases.
Management
- Early safe mobility, transfers, and gait
- Scapular and deltoid strength
- Range and functional reach exercises
- Education for joint protection and home setup
- Follow-up reviews to monitor the implant and progress
Rehabilitation milestones
Phase 1 days 0 to 7: pain control, assisted range, independent transfers.
Phase 2 weeks 1 to 6: active range within limits, light strength, stairs and self-care.
Phase 3 weeks 6 to 12: progressive strength, balance, community mobility.
Phase 4 months 3 to 6: return to chosen activities and work demands.
Readiness to progress
- Pain and swelling are controlled
- Stable gait and safe stair negotiation
- Strength and range targets met for daily tasks
Long-term care
- Maintain strength and a healthy weight
- Avoid repeated heavy impact unless cleared
- Attend regular reviews as advised
Australia snapshot
- Shoulder arthroplasty volumes grow steadily in public and private systems
- Reverse replacement is common when the cuff is deficient
- Community rehabilitation services support discharge home
Latest insights
Prehabilitation and early mobility significantly influence the recovery curve.
Strength and confidence predict independence more than the choice of implant.
