SHOULDER REPLACEMENT
Reverse Shoulder Replacement
vs. Total Shoulder Replacement
Patients are often surprised to learn there are two different types of shoulder replacement. Choosing the correct operation is one of the most important decisions in shoulder surgery. The best procedure depends on your diagnosis, rotator cuff function, bone quality, and long-term goals—not simply your age.
Healthy Rotator Cuff
Rotator Cuff Not Required
Diagnosis Driven
Restore Function
What Is The Difference?
Although both operations replace the arthritic shoulder joint, they function very differently.
A total shoulder replacement recreates normal shoulder anatomy and depends on a healthy, functioning rotator cuff to move and stabilize the joint.
A reverse shoulder replacement changes the mechanics of the shoulder so that the deltoid muscle becomes the primary elevator of the arm. This allows many patients with severe rotator cuff damage to regain excellent shoulder function.
Dr. Streit's Clinical Perspective
Patients often ask me which operation is "better." Neither operation is better—they are designed for different problems. The key is selecting the procedure that best matches your shoulder.
When Is A Total Shoulder Replacement Recommended?
Primary Osteoarthritis
Healthy Rotator Cuff
Good Bone Quality
Inflammatory Arthritis
Preserved Shoulder Mechanics
Intact Tendons
When Is A Reverse Shoulder Replacement Recommended?
Irreparable Rotator Cuff Tear
Rotator Cuff Tear Arthropathy
Complex Proximal Humerus Fracture
Revision Shoulder Replacement
Failed Previous Surgery
Selected Severe Glenoid Deformity
Why Does The Rotator Cuff Matter?
The primary purpose of the rotator cuff is to stabilize the shoulder by keeping the ball centered within the socket during motion.
A traditional total shoulder replacement relies on that stabilizing function. If the rotator cuff is no longer capable of performing its job, the artificial joint may not function normally.
A reverse shoulder replacement changes the mechanics of the shoulder so that the deltoid muscle can elevate the arm even when the rotator cuff is no longer functional.
What I Tell My Patients
"The question isn't whether you need a shoulder replacement. The question is which shoulder replacement will give you the best long-term shoulder function."
How Do I Decide Which Operation You Need?
Every patient undergoes a comprehensive evaluation before surgery.
History
Understanding your symptoms and goals.
Physical Examination
Evaluating motion, strength, and rotator cuff function.
X-rays
Assessing arthritis, alignment, and bone loss.
Advanced Imaging
CT or MRI when additional information is needed for surgical planning.
Will Recovery Be Different?
Both procedures require structured rehabilitation, but the details of recovery depend on the diagnosis, the operation performed, and your individual goals. Most patients experience steady improvement over many months as the shoulder regains strength and function.
Related Resources
Not Sure Which Shoulder Replacement Is Right For You?
A comprehensive shoulder evaluation can determine which procedure is most appropriate for your anatomy, diagnosis, and long-term goals, helping maximize pain relief and restore durable shoulder function.
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