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Anatomic Total Shoulder Replacement

Resurfacing of the ball and socket while preserving the ball-and-socket geometry.

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Anatomic replacement may be considered for painful arthritis when the rotator cuff functions adequately. Damaged joint surfaces are replaced while preserving the usual shoulder orientation.

When is anatomic shoulder replacement considered?

Typical considerations include established cartilage loss, loss of function, symptoms that remain unacceptable despite nonsurgical treatment, and a rotator cuff capable of supporting the reconstructed joint.

How it is different from reverse shoulder replacement

Anatomic replacement preserves the natural position of the ball and socket and depends on cuff function. A reverse replacement alters the mechanics to make the deltoid more effective. A preoperative exam and imaging help determine which design is most appropriate.

What happens before the procedure?

Careful review of your medical history, radiographs and sometimes advanced imaging helps assess bone shape, cuff integrity, and implant choices. Dr. Haber will also discuss medication management, medical clearance when needed, postoperative home support and rehabilitation.

Recovery after anatomic shoulder replacement

Passive range of motion (PROM) means your shoulder is moved with help, without the shoulder muscles lifting the arm. Active range of motion (AROM) means you move the arm using your own muscles. Both follow the limits in your physical therapy protocol.

  1. Weeks 0–4: protect the shoulder. Wear your sling or shoulder immobilizer for the first 4 weeks. Gentle passive shoulder motion is encouraged within your prescribed limits.
  2. Physical therapy starts within 1 week. Attend once a week while in the sling, focusing on passive motion to help prevent stiffness. After 4 weeks, Dr. Haber generally recommends physical therapy twice a week until your motion goals are met.
  3. After 4 weeks: begin gentle active motion. When cleared to come out of the sling, begin moving the shoulder with your own muscles and using the arm for simple daily tasks. Keep lifting and loading through the arm limited to approximately 3–5 pounds.
  4. Following months: rebuild movement and strength. Gradually improve motion and smooth, controlled shoulder movement, then build strength with your therapist’s guidance.
  5. Around 4.5–6 months: return to approved activities. Return to golf, pickleball, skiing and other activities is gradual and requires clearance based on healing, motion, strength and your specific surgery. Contact sports and repetitive heavy lifting may remain restricted after replacement; discuss long-term activity limits with Dr. Haber.

Preventing stiffness is a priority

Stiffness is a major concern after shoulder surgery. Physical therapy is essential to restoring motion and function while protecting healing tissue. Dr. Haber works with trusted therapists across the Front Range and recommends a therapist based on where you live.

Shoulder recovery guide: ice therapy, sleep and dressing tips →

A decision based on your priorities

Many shoulder symptoms can be managed without replacement. The goal is not to steer every patient toward an operation; it is to provide a clear explanation of the evidence, trade-offs, likely benefits and risks.

Common questions

Does anatomic shoulder replacement require an intact rotator cuff?

It generally requires a functional rotator cuff to keep the joint stable and support motion. Your surgeon evaluates tendon function and imaging before recommending the implant.

Is shoulder replacement performed for arthritis alone?

Painful advanced arthritis is one common indication. The decision also considers function, prior treatment, overall health, the condition of the rotator cuff and patient preferences.

3D planning tailored to your shoulder

For shoulder replacement, Dr. Haber uses patient-specific, computer-generated 3D imaging to assess bone shape, implant sizing and component alignment before surgery. Detailed planning can help guide positioning in both routine and complex anatomy; occasionally a custom implant may be ordered when anatomy warrants it. These tools are intended to improve planning precision, not to guarantee an outcome. Read about advanced shoulder planning →