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Total Shoulder Arthroplasty

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Total shoulder replacement for severe arthritis — stemless options if rotator cuff is intact.

Updated May 2026

Illustration of a person with their arm resting in a sling while a physiotherapist adjusts the strap. — A total shoulder replacement: a metal ball is fixed to the upper arm bone and a plastic socket is anchored to the shoulder blade — recreating the natural ball-and-socket shape. Kieran Hirpara 4.0

Why this operation has been suggested¶

This page reflects how Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, approaches this in our clinic. We recommend total shoulder replacement when wear-and-tear arthritis or injury causes pain and stiffness that limits your daily life. You typically reach our clinic via a GP or physiotherapist referral. We assess your history, examine your shoulder, and review imaging to confirm the diagnosis.

For long-standing wear, we usually try non-operative care first. This includes activity changes, physiotherapy, and injections. We consider surgery when these steps do not give enough improvement. For some structural problems, surgery may be recommended sooner. The operation replaces the damaged joint surfaces with artificial parts to relieve pain and restore movement. Most patients regain fundamental strength and range of motion after the procedure.

Before the operation¶

We prepare you for a safe procedure using a single conventional incision. You must fast before surgery and stop certain medications as directed by your surgeon. Please arrange a lift home and bring a list of your current medicines in comfortable clothing. We may order X-rays, MRI, blood tests, or an anaesthetic review beforehand. These checks help us understand your bone quality and overall health. This ensures we choose the right approach for your shoulder. Your surgeon will provide specific instructions on which medications to pause. Following these steps helps reduce risks and supports a smoother recovery. We are here to guide you through every step of this preparation.

On the day¶

You will arrive at the hospital for admission and check-in. Our team will guide you through the final preparations. This operation is done under general anaesthetic combined with a regional nerve block. You will be fully asleep for the operation, and the block — an injection that numbs the nerves supplying the arm before you wake up — provides pain relief for the first 12 to 24 hours after surgery. The anaesthetist will meet you before the operation and talk you through both parts.

We perform this surgery using a single conventional incision over the shoulder. You will be moved to the operating theatre once you are ready. After the procedure, you will wake up in our recovery area. Our staff will monitor your comfort and vital signs closely. You can expect to rest while the anaesthetic wears off. We will provide clear instructions for your next steps before you leave.

What the operation involves¶

Your surgeon makes a single cut about 8 to 10 cm long over the front of your shoulder. This open approach gives clear access to the joint. We carefully move muscles aside to reach the worn bone and cartilage. Your surgeon removes these damaged surfaces. The joint is then replaced with metal and plastic parts. These components are fixed securely to your bone to restore smooth movement.

We close the cut with stitches or staples. A dressing is applied to protect the area. The procedure typically takes between 1 and 2 hours. This timeframe allows for careful positioning of the new joint parts.

Outpatient total shoulder arthroplasty is a safe option for selected patients. This means you may go home the same day. It offers reduced costs and improved access compared to staying in hospital. Your surgeon will discuss if this setting is right for you.

Rehabilitation aims to relieve pain and improve function. We guide you through exercises to protect the new joint. Some newer programs allow immediate movement after surgery. However, we tailor this to your specific needs and safety. Strict technique during the operation is crucial for reliable results. This includes proper repair of shoulder muscles and correct stem position.

After the operation¶

You will wake up in a recovery ward where your pain is managed. We keep your shoulder supported in a sling with dressings over the incision. Most patients stay one night in hospital after this operation, though some are able to go home the same day. You must have someone stay with you for the first 24 hours. This surgery uses an open approach with a single conventional incision over the operative site. You cannot drive while in a sling or for at least SIX WEEKS after any shoulder operation, regardless of which arm was operated on. Once your surgeon clears you, typically at the six-week review, you may resume driving. Please read our guide on Driving after upper-limb surgery for full details.

Recovery¶

You will have a single incision over your shoulder. In the first few days, swelling and stiffness are normal. Your arm will rest in a sling to protect the repair. We keep you comfortable with prescribed pain relief. The sharp ache usually fades into a dull soreness as the swelling settles.

Your physiotherapist guides your rehabilitation. You will start gentle movements early to prevent stiffness. These exercises focus on restoring motion and strength. You must keep your sling on for daily activities until your surgeon advises otherwise. Avoid lifting, pushing, or pulling with the operated arm. Sleep may be difficult at first; propping yourself up with pillows often helps.

As your range of motion returns, you will gradually resume light household tasks. You can return to work or sport once your surgeon clears you and your strength improves. Driving is not permitted while in a sling. Our policy requires no driving for at least six weeks after any shoulder operation, regardless of which arm was treated. You may drive only once your surgeon clears you, typically at the six-week review. See our guide on Driving after upper-limb surgery for details.

Recovery varies between individuals. Your timeline may differ; your surgeon and physio will guide you based on your progress.

What can go wrong¶

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

Infection is a serious risk. You might notice redness that spreads from the wound, warmth, or pus draining out. A deep, throbbing pain that does not ease with simple painkillers is also a sign. You may develop a fever or feel generally unwell. If you see these signs, call the clinic immediately or go to the emergency department. Early treatment is vital to protect your new joint.

Bleeding can sometimes form a bulge under the skin. This is called a pseudoaneurysm. You might feel a pulsing lump or notice sudden swelling near the incision. It is uncommon but possible. Contact your surgeon right away if you feel a new, pulsating mass.

Your shoulder may feel unstable or slip out of place. This is called dislocation. You might hear a loud pop or feel a sudden shift in the joint. The arm may feel weak or unable to move normally. If this happens, do not try to force it back. Seek urgent medical help to get it reduced safely.

Bone breaks can occur around the implant. This is a periprosthetic fracture. You might feel a sharp, sudden pain after a minor bump or fall. Swelling and bruising will likely appear quickly. If you suspect a break, keep the arm still and seek emergency care.

Your blood clotting levels might be off if you take certain medications. High levels of a substance called INR can increase complication risks. If you are on blood thinners or testosterone, tell your surgeon. They will check your levels before surgery to keep you safe.

Some patients face higher risks due to their age or health background. Older adults or those from areas with high social deprivation may face more fractures or dislocations. Smoking can also affect healing. Be honest about your health history so we can plan the best care for you.

The complications table on this page lists typical rates if you want the specifics.

When to call us¶

Call us if you have a fever, increasing wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling or shortness of breath. Seek urgent care for loss of sensation or inability to move your limb. These signs need immediate assessment to keep your recovery on track.

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