Upper Limb — Arthroplasty
Shoulder Hemiarthroplasty
Shoulder hemiarthroplasty is a procedure where only the humeral head (the “ball” of the shoulder joint) is replaced, while the glenoid socket is preserved. It is most commonly used in selected fracture patterns and specific arthritis/AVN cases where the socket surface is relatively healthy.
When is Shoulder Hemiarthroplasty Recommended?
This procedure is not for every patient. It is chosen when replacing only the humeral head is expected to provide good pain relief and function, and when the glenoid surface is not the main problem.
- Selected proximal humerus fractures where reconstruction is not reliable
- Avascular necrosis (AVN) of the humeral head with a preserved socket
- Arthritis in carefully selected patients with minimal glenoid wear
- Young or active patients where preserving the glenoid is preferred in specific scenarios
If the glenoid is also damaged, surgeons often consider anatomic total shoulder arthroplasty. If the rotator cuff is irreparable, reverse shoulder arthroplasty may be the better option.
How Hemiarthroplasty Works
In shoulder hemiarthroplasty, the damaged humeral head is replaced with a metal implant. Because the socket is not resurfaced, outcomes depend heavily on:
- Quality of the glenoid cartilage
- Rotator cuff and muscle balance
- Accurate implant positioning
- Rehabilitation and shoulder mechanics
For fracture cases, healing and positioning of the tuberosities (where rotator cuff tendons attach) plays a major role in final strength and motion.
Procedure Overview
- Imaging (X-ray/CT) to assess fracture pattern and joint surfaces
- Pre-op planning for implant size and restoration of shoulder length
- Replacement of the humeral head component
- Soft-tissue balancing and stability check
- Early physiotherapy with a phased protocol
How long does surgery take?
Often around 1.5–3 hours, depending on whether it’s done for fracture or arthritis/AVN.
Hospital stay
Many patients stay 1–3 nights, depending on pain control and early rehab goals.
Recovery Timeline
| Phase | Timeline | Focus |
|---|---|---|
| Protection | 0–2 weeks | Sling, wound care, pain control |
| Motion | 2–6 weeks | Passive → active-assisted movement |
| Strength | 6–12 weeks | Progressive strengthening |
| Function | 3–6 months | Return to daily activities |
Recovery speed varies based on the reason for surgery (fracture vs AVN/arthritis) and physiotherapy compliance.
Risks and Realistic Expectations
- Infection, bleeding, or nerve irritation
- Stiffness if rehabilitation is delayed
- Persistent pain if the glenoid has hidden wear
- Dislocation risk in early healing phase
- For fractures: tuberosity non-union or malposition affecting strength
General patient information on shoulder replacement is available here: AAOS — Shoulder Joint Replacement .
Shoulder Hemiarthroplasty FAQs
What is the difference between hemiarthroplasty and total shoulder replacement?
Hemiarthroplasty replaces only the humeral head. Total shoulder replacement resurfaces both the humeral head and the glenoid socket.
Who is a good candidate for shoulder hemiarthroplasty?
Selected fracture cases, AVN with preserved glenoid cartilage, and carefully chosen arthritis cases where the socket is relatively healthy.
How long do implants last?
Longevity depends on diagnosis, activity level, and glenoid health. Many implants function well for years with appropriate care.
When can I return to work?
Desk work may be possible in 2–4 weeks. Physical work usually takes longer and depends on healing and rehab progress.
Will I need physiotherapy?
Yes. Physiotherapy is essential to restore motion and strength, especially after fracture-related hemiarthroplasty.
Book a Consultation
If you’re considering shoulder hemiarthroplasty, a consultation helps confirm whether this option is appropriate or whether TSA or reverse replacement is more suitable.