Shoulder replacement (Shoulder arthroplasty)

An operation that replaces the worn or damaged surfaces of the shoulder joint with artificial parts to reduce pain and, in many people, improve movement.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A shoulder replacement is mainly done to relieve long-standing pain from a worn or damaged joint, not to make the shoulder like new.
Pain relief is usually the most reliable result; how much movement and strength you get back varies a lot from person to person.
Recovery is gradual — a sling for a few weeks, then months of physiotherapy before the shoulder feels settled.
It is major surgery with real risks, so it is usually offered only after painkillers, injections and physiotherapy have been tried.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMajor joint replacement surgery

AnaestheticGeneral anaesthetic, usually with a nerve block

How long it takesAbout 1.5–3 hours

Hospital stayUsually 1–3 nights in hospital

Time off workSeveral weeks; a sling for around 3–6 weeks and months of rehab

When you'll see resultsPain often eases within weeks; movement and strength build over many months

On the NHS?Commonly available on the NHS when arthritis or a damaged joint causes lasting pain and disability; private care may be used for speed or choice

A general guide. Your surgeon will give you advice for your situation.

Best fit

Often gives good, lasting relief from arthritic shoulder pain, including pain at night

Pause if

You have an active infection in or near the shoulder, or a serious infection elsewhere in the body.

Main recovery point

Your arm is in a sling. The team controls pain and may start very gentle, guided movements. Most people go home after one to three nights.

Good aftercare

A clear written rehabilitation plan with physiotherapy and milestones.

First few days

Your arm is in a sling. The team controls pain and may start very gentle, guided movements. Most people go home...

Weeks 1–3

You wear the sling much of the time and follow your physiotherapist's gentle exercises. The wound heals and...

Weeks 3–6

You gradually wean off the sling as advised and increase movement. You can usually manage light everyday tasks at...

6 weeks–3 months

Physiotherapy steps up to build movement and then strength. Many people notice steady improvement in comfort and...

Medical line illustration of shoulder replacement for Shoulder replacement. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is a shoulder replacement?

A shoulder replacement (shoulder arthroplasty) is an operation in which a surgeon removes the worn, arthritic or damaged surfaces of the shoulder joint and replaces them with artificial parts made of metal and plastic. It is usually done to relieve long-standing pain and stiffness that have not settled with painkillers, injections and physiotherapy.

The shoulder is a ball-and-socket joint. In an 'anatomical' replacement the parts copy the normal shape — a new ball on the arm bone and, often, a new socket. In a 'reverse' replacement the ball and socket are swapped over, which lets the larger deltoid muscle power the arm when the rotator cuff tendons are torn or worn out. Your surgeon chooses the type based on your X-rays, the state of your tendons and your bone.

A shoulder replacement is mainly an operation to reduce pain. Many people also regain useful movement, but it does not always restore a full, normal range, and heavy overhead or contact activity is usually limited for life. It will not turn an old shoulder into a young one.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Anatomical total shoulder replacement

Replaces both the ball (top of the arm bone) and the socket with parts shaped like the normal joint. Used mainly for osteoarthritis when the rotator cuff tendons are still working well.

Reverse total shoulder replacement

Swaps the ball and socket around so the deltoid muscle does more of the work. Used when the rotator cuff is badly torn or worn, for some fractures, and for failed previous surgery.

Hemiarthroplasty (half replacement)

Replaces only the ball at the top of the arm bone, leaving the natural socket. Sometimes used for certain fractures or particular joint problems.

Resurfacing replacement

Caps the worn ball with a metal surface rather than removing the whole top of the bone. Used less often, in selected people, to preserve more bone.

Anatomical vs reverse shoulder replacement

Feature	Anatomical	Reverse
Best when	Cuff tendons intact	Cuff torn or worn
What it relies on	Rotator cuff	Deltoid muscle
Overhead reach	Often good	Often improved but can be limited
Common reasons	Osteoarthritis	Cuff tear arthritis, some fractures, revision

Your surgeon decides the right type from your X-rays, scans and the state of your tendons. Both are well-established operations.

Preparing for your surgery

See the operating surgeon, who will examine your shoulder and review X-rays or scans to confirm a replacement is the right step and which type suits you.
Have a pre-operative assessment to check your general health, blood pressure, heart and any other conditions before a general anaesthetic.
Tell the team about all medicines, especially blood thinners (such as warfarin, apixaban, clopidogrel) and diabetes medicines, which may need adjusting.
Stop smoking and reduce alcohol beforehand if you can, as this lowers the risk of wound and chest problems and helps healing.
Plan for a sling for several weeks and arrange help at home for washing, dressing and cooking, as one arm will be out of action.
Set up your home so things you use often are within easy reach at waist height, and arrange a lift home and to early appointments.
Ask about a physiotherapy plan, as rehabilitation is a major part of the result.

What happens

Shoulder replacement is normally done under a general anaesthetic, often combined with a nerve block that numbs the arm and helps with pain afterwards. You are usually asleep for the operation.

The surgeon makes a cut at the front of the shoulder, moves the muscles aside, removes the worn surfaces and fits the new parts. Some components are pressed into the bone and some are fixed with bone cement. The cut is closed with stitches or clips and covered with a dressing, and your arm is placed in a sling.

The operation usually takes around one and a half to three hours. Afterwards you recover on the ward, start gentle movements with a physiotherapist when the team advises, and most people stay in hospital for one to three nights.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

You have an active infection in or near the shoulder, or a serious infection elsewhere in the body.
Your pain and disability are mild and likely to respond to painkillers, injections and physiotherapy.
You are unable to take part in the rehabilitation needed to get a good result.
Your bone or soft tissues are too damaged to support an implant, or your general health makes major surgery too risky.
Your expectations are for a fully normal, young shoulder rather than pain relief and improved function.

Delay surgery if…

You have a current infection, skin breakdown over the shoulder, or dental or other infection that should be treated first.
Your general health, diabetes control, blood pressure or heart condition is unstable and could be optimised before a general anaesthetic.
You are still smoking heavily, as stopping first lowers wound and chest risks.
You have not yet had a proper trial of non-surgical treatment and a chance to weigh it up.
You cannot yet arrange the help at home and rehabilitation that recovery needs.

Alternatives to discuss

Painkillers and anti-inflammatory medicines, used carefully.
Physiotherapy to strengthen the muscles around the shoulder and improve movement.
Steroid or other joint injections for temporary relief.
Activity changes and pacing to reduce strain on the joint.
Continuing to wait and review if symptoms are tolerable, since a replacement can usually be done later.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

Most shoulder replacements are done with you fully asleep.

Regional nerve block

An injection that numbs the arm, usually combined with a general anaesthetic to reduce pain afterwards.

Benefits

Often gives good, lasting relief from arthritic shoulder pain, including pain at night
Can improve the ability to do everyday tasks such as dressing, washing and reaching
May improve movement, though how much varies and is not guaranteed
For some fractures or failed previous surgery, can restore a working shoulder when other options are limited
Modern implants commonly last many years, with most still working well at ten years

Risks & complications

More common

Pain, bruising and swelling around the shoulder in the early weeks
Stiffness and a range of movement that is improved but not fully normal
A scar at the front of the shoulder
Temporary numbness or tingling in the arm from the nerve block or positioning

Less common

Wound infection needing antibiotics
A crack in the bone (fracture) during or after surgery
The new joint slipping out of place (dislocation), more relevant for reverse replacements
Ongoing pain despite a technically good operation
Blood clot in the leg or lung (DVT or pulmonary embolism)

Rare but serious

Deep infection around the implant, which can need further surgery
Lasting nerve injury affecting arm or hand movement or feeling
Loosening or wear of the components over time, which may need a revision operation
Serious anaesthetic, heart or chest complications

The biggest issues to discuss are the chance of ongoing stiffness or pain even when surgery goes to plan, the risk of deep infection (which is serious around any joint replacement), and how long the implant is likely to last for someone your age and activity level. Ask your surgeon how many shoulder replacements they do each year and what their own results and complication rates are.

Published figures to discuss

Outcomes and complication rates vary with the type of replacement, the reason for surgery, your age, bone quality and the state of your tendons, and with how active you are afterwards. Registry figures describe averages across many patients and surgeons, so your own surgeon's results and your individual health matter. Rates below are cautious and drawn from UK registry and published data.

Figure	Reported range	How to interpret it	Source / confidence
Need for a further procedure within 3 months	Up to about 5% in NHS patient information	Higher in people over 80 and in men; covers complications needing more surgery soon after the operation.	Leeds Teaching Hospitals NHS Trust — Shoulder replacementleedsth.nhs.ukPublished figure
Implant still working at around 10 years	Over 90% in UK registry data for common indications; revision risk varies by implant type and indication	Revision rates are generally in the low single digits at five years, rising towards roughly 5% by nine to ten years.	Reverse vs anatomical shoulder replacement — National Joint Registry / HES study (PMC)pmc.ncbi.nlm.nih.govPublished figure
Fracture during surgery	Around 1–2% in some series	Usually a crack that can be managed at the time; reported intraoperative complication rates of about 2–3% are mostly fractures.	Reverse vs anatomical shoulder replacement — National Joint Registry / HES study (PMC)pmc.ncbi.nlm.nih.govPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery from a shoulder replacement is gradual and measured in months rather than weeks. Pain often improves quite early, but rebuilding movement and strength is a slow process that depends heavily on doing your physiotherapy.

First few days

Your arm is in a sling. The team controls pain and may start very gentle, guided movements. Most people go home after one to three nights.

Weeks 1–3

You wear the sling much of the time and follow your physiotherapist's gentle exercises. The wound heals and stitches or clips are usually removed around 10–14 days.

Weeks 3–6

You gradually wean off the sling as advised and increase movement. You can usually manage light everyday tasks at waist height. Driving is typically possible once you have safe control of the arm and your surgeon agrees, often around six weeks.

6 weeks–3 months

Physiotherapy steps up to build movement and then strength. Many people notice steady improvement in comfort and function.

3–12 months

Strength and confidence continue to build. The final result is usually judged at around six to twelve months.

What's normal — and not a worry

Aching and swelling that gradually settle over the first weeks
A shoulder that feels weak and stiff at first and improves slowly with exercises
Tiredness while your body heals from major surgery
Clicking or unfamiliar sensations from the new joint as you get used to it
Slow, steady gains rather than a sudden return to normal

Aftercare

Wear your sling exactly as instructed and do your prescribed exercises — rehabilitation is a major part of the result.
Take pain relief as advised so you can move comfortably and sleep.
Keep the wound clean and dry until it has healed and follow advice on showering and dressings.
Avoid lifting, pushing, pulling and reaching beyond the limits your surgeon sets in the early weeks.
Do not drive until you have safe control of the arm and your surgeon and insurer are satisfied.
Attend physiotherapy and follow-up appointments so progress and healing are checked.
Tell your dentist and other doctors that you have a joint replacement, as antibiotic advice may apply for some procedures.

Before-surgery checklist

Sling fitted and instructions understood
Pain relief collected and a plan for taking it
Help at home arranged for washing, dressing and meals
Physiotherapy appointments booked
Loose, easy-to-wear clothing ready (front-opening tops help)
Lift home and to early appointments arranged
Clinic's contact number saved for problems

Scars and how they heal

There is usually a scar at the front of the shoulder where the cut is made. It is firm and pink at first and normally fades over several months. Keeping it clean while healing and protecting it from strong sun helps it settle.

⚠ Get urgent help if…

Increasing redness, heat, swelling or discharge from the wound (possible infection)
A fever or feeling generally unwell after surgery
Severe or worsening shoulder pain not helped by your usual pain relief
Calf pain, swelling or redness, or sudden breathlessness or chest pain (possible clot — seek urgent help)
New weakness, numbness or loss of movement in the arm or hand
A feeling that the joint has slipped or popped out of place

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result usually means much less pain, better sleep and an easier time with everyday tasks. Many people also gain useful movement, but the amount varies and a fully normal range is not guaranteed, especially with reverse replacements or when tendons were badly damaged.

Results take time to show fully — comfort often improves within weeks, but movement and strength build over six to twelve months. A shoulder replacement does not make the shoulder young again, and heavy or repeated overhead and contact activity is usually limited for life to protect the implant.

How long it lasts

Modern shoulder replacements commonly last many years, and UK registry data suggest most are still working well at around ten years, with revision rates generally in the low single digits at five years and roughly 5% or so by nine to ten years for common indications. How long any individual implant lasts depends on the type, your age, bone quality, activity level and the state of the surrounding muscles. Younger and more active people tend to put more demand on the joint, which can shorten its life.

Combining with other procedures

Shoulder replacement is usually a single operation rather than something combined with other procedures. If both shoulders are affected, surgeons normally treat one at a time so you keep the use of one arm during recovery.

Follow-up & long-term care

You will be reviewed after surgery to check the wound and your progress, and physiotherapy continues for months. Many surgeons arrange periodic X-rays over the years to check the implant. Report any new pain, swelling, fever or loss of function promptly.

Keep up the strengthening and movement exercises your physiotherapist gives you, even after formal sessions end.
Avoid heavy lifting and repeated overhead or contact activities that put extra strain on the implant.
Attend any review X-rays so loosening or wear can be picked up early.
Tell other clinicians and your dentist that you have a joint replacement so they can advise on antibiotics where relevant.

Revision and secondary surgery reality

Implants can loosen, wear or become infected over many years and may need a revision operation.
Revision shoulder surgery is generally bigger, with a higher complication rate than the first operation.
A failed anatomical replacement is sometimes revised to a reverse replacement.
Younger, more active people are more likely to need revision in their lifetime because they place more demand on the joint.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

A clear written rehabilitation plan with physiotherapy and milestones.
A named contact and a number to call if you have wound, pain or fever concerns.
Planned follow-up and review X-rays over the years to check the implant.
Clear advice on sling use, driving, work and the activities to avoid.
Prompt assessment if infection, a clot or sudden loss of function is suspected.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

The operating surgeon's fee and the anaesthetist's fee
Theatre and hospital facility charges, and the length of your stay
The type of implant used (anatomical, reverse, hemiarthroplasty) and its components
The complexity of your case, including revision surgery or difficult anatomy
Physiotherapy and rehabilitation, which are a major part of recovery
Follow-up appointments and any X-rays over time
Cover for managing complications if they occur

Make sure your written quote includes

The surgeon's fee and the anaesthetist's fee
Theatre, hospital stay and the implant itself
How many physiotherapy sessions are included and for how long
Follow-up appointments and X-rays
What happens, and who pays, if a complication or readmission occurs
The cancellation policy
Whether revision surgery would be covered if the implant failed

On the NHS? Shoulder replacement is commonly funded by the NHS when arthritis or joint damage causes lasting pain and disability that has not improved with other treatment; private care is sometimes used for a shorter wait, choice of surgeon or a second opinion.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Which type of replacement do you recommend for me, and why?
What is the state of my rotator cuff, and how does that affect my likely movement afterwards?
How many shoulder replacements do you perform each year, and what are your own results and complication rates?
How much pain relief and movement can I realistically expect, and what will stay limited?
What does my rehabilitation plan involve, and how long before I can drive and return to work?
What would a revision operation involve if the implant ever wore out or loosened?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Is a shoulder replacement available on the NHS?

Yes, it is commonly available on the NHS when arthritis or a damaged joint causes lasting pain and disability that has not responded to other treatment. Some people choose private care for a shorter wait or a particular surgeon.

How long will the new shoulder last?

Many last well beyond ten years, and most are still working at around ten years in UK registry data. The exact lifespan depends on the implant type, your age, bone quality and how active you are.

Will I get full movement back?

Pain relief is the most reliable result. Many people regain useful movement, but a fully normal range is not guaranteed, and heavy overhead activity is usually limited for life.

How long until I can drive and return to work?

Driving is often possible around six weeks once you have safe control of the arm and your surgeon agrees. Return to work depends on your job — desk work may be a few weeks, manual work considerably longer.

What is the difference between an anatomical and a reverse replacement?

An anatomical replacement copies the normal joint and relies on the rotator cuff. A reverse replacement swaps the ball and socket so the deltoid muscle powers the arm, which helps when the cuff is torn or worn. Your surgeon chooses based on your tendons and X-rays.

What is the most serious risk?

Deep infection around the implant is uncommon but serious and can need further surgery. Clots, fractures, nerve injury and loosening over time are also important to discuss. Your surgeon can give you figures relevant to your situation.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Leeds Teaching Hospitals NHS Trust — Shoulder replacement Frimley Health NHS Foundation Trust — Shoulder replacement surgery British Elbow & Shoulder Society — Patient information Reverse vs anatomical shoulder replacement — National Joint Registry / HES study (PMC) Reverse shoulder arthroplasty survivorship by indication (PMC) NHS — Osteoarthritis Revision rates after shoulder replacement — systematic review (PMC) National Joint Registry reports — executive summary

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.