Shoulder replacementMatched to your rotator cuff.

Your shoulder is a ball-and-socket joint. The rotator cuff, a group of four muscles and tendons, keeps the ball centered in the socket and helps lift and rotate the arm.

• Anatomic total shoulder replacement resurfaces the joint the way nature built it: a smooth metal ball on the upper arm bone and a plastic socket. It's generally the choice for bone-on-bone osteoarthritis when the rotator cuff is intact.
• Reverse total shoulder replacement switches the ball and socket. The metal ball goes on the shoulder blade and the cup goes on the arm bone. This lets the strong deltoid muscle lift the arm instead of the rotator cuff.

Anatomic replacement is often recommended for:

• Osteoarthritis with healthy rotator cuff tendons
• Enough bone in the socket to support the implant

Reverse replacement is often recommended for:

• A large rotator cuff tear that can't be repaired, with or without arthritis (cuff tear arthropathy)
• Complex fractures of the upper arm, especially in older patients
• A failed earlier shoulder replacement
• Arthritis with severe socket wear or deformity

Surgery is considered when shoulder pain limits your daily life, disturbs your sleep and hasn't improved with medication, injections and physical therapy. Read more about why reverse shoulder replacement is growing.

Every shoulder is shaped a little differently, and arthritis often wears the socket unevenly. Before surgery, a CT scan of your shoulder is turned into a three-dimensional model. Dr. Akhtar uses 3D planning software to choose the implant size and to plan exactly where and at what angle the socket component will sit, taking into account any bone wear.

The plan is made before you reach the operating room, so the surgery follows a blueprint built around your anatomy, much as he plans Mako knee replacements from a CT scan.

• Meaningful improvement. In the American Academy of Orthopaedic Surgeons' shoulder registry, shoulder scores roughly doubled one year after replacement, and more than 8 in 10 patients improved by a clinically meaningful amount. AAOS Shoulder & Elbow Registry 2026 Annual Report.
• Durable. In a long-term study of reverse shoulder replacement, 93% of implants were still in place at an average of 12.5 years. Bacle G, et al. J Bone Joint Surg Am. 2017.
• Getting back to activities. Across studies, 92.6% of patients returned to sports after anatomic replacement and 74.9% after reverse replacement. Liu JN, et al. Knee Surg Sports Traumatol Arthrosc. 2018;26(1):100–112.

Individual results vary with your condition, health and rehabilitation.

Typical milestones described by the American Academy of Orthopaedic Surgeons:

• Day of surgery or next day: some patients go home the same day; most others go home the next day.
• 2 to 6 weeks: the arm stays in a sling. Gentle therapy starts soon after surgery, plus a home exercise program.
• About 2 weeks: most people can eat, dress and groom themselves.
• 2 to 6 weeks: no driving, and lift nothing heavier than a glass of water.
• First 6 weeks: avoid extreme arm positions, such as reaching behind your back.
• Long term: avoid contact sports and repetitive heavy lifting.