Upper Limb — Arthroplasty
Anatomic Total Shoulder Arthroplasty (TSA)
Anatomic total shoulder arthroplasty is a proven shoulder replacement procedure used to treat advanced shoulder arthritis when the rotator cuff is intact. The goal is long-term pain relief, smoother motion, and restoration of normal shoulder mechanics after conservative treatments stop working.
Indications for Anatomic Total Shoulder Arthroplasty
This procedure is recommended when shoulder pain and stiffness significantly affect daily life despite medicines, injections, or physiotherapy.
- Advanced glenohumeral osteoarthritis
- Inflammatory arthritis such as rheumatoid arthritis
- Post-traumatic arthritis after shoulder injury
- Avascular necrosis of the humeral head
- Intact and functional rotator cuff tendons
If the rotator cuff is not repairable, reverse shoulder replacement may offer better functional outcomes.
How Anatomic Total Shoulder Arthroplasty Is Performed
The surgery replaces both sides of the shoulder joint in a way that closely replicates natural anatomy.
- Pre-operative imaging to assess bone and cuff integrity
- Deltopectoral approach under general anesthesia
- Metal replacement of the humeral head
- Polyethylene resurfacing of the glenoid socket
- Careful balancing of soft tissues
How long does surgery take?
Most procedures take 1.5 to 3 hours, depending on complexity.
Recovery After Surgery
Recovery is gradual and guided by physiotherapy to protect the implant and restore function safely.
| Phase | Timeframe | Focus |
|---|---|---|
| Protection | 0–2 weeks | Sling, pain control |
| Motion | 3–6 weeks | Active-assisted movement |
| Strength | 6–12 weeks | Muscle strengthening |
| Function | 3–6 months | Return to daily activities |
Key Benefits of This Procedure
- Reliable and long-term pain relief
- Improved shoulder motion
- Restoration of near-normal joint mechanics
- High implant survival in properly selected patients
Frequently Asked Questions
Who is a good candidate?
Patients with advanced arthritis and an intact rotator cuff who have failed conservative treatment.
How long do implants last?
Modern implants often last 15–20 years or longer with activity modification.
Is this better than reverse shoulder replacement?
It is preferred when the rotator cuff is intact. Reverse replacement is used when it is not.
When can I return to work?
Desk work may resume in 2–4 weeks. Heavy work may take 3–6 months.
Considering Shoulder Replacement?
A consultation helps decide whether this procedure or another form of shoulder replacement surgery is right for you.