Shoulder Arthritis & Shoulder Replacement
What Is Shoulder Arthritis & Shoulder Replacement?
Shoulder arthritis is the gradual wearing away of the cartilage that cushions your shoulder joint, causing bone to grind against bone, pain, and stiffness. When arthritis, a prior injury, or a previous surgery has damaged the joint beyond what physical therapy or injections can manage, a shoulder replacement removes the damaged surfaces and replaces them with an artificial ball and socket. There are two main types: anatomic total shoulder replacement (regular), which recreates your shoulder's natural ball-and-socket anatomy, and reverse total shoulder replacement, which reverses the ball and socket to let other muscles compensate for a damaged or non-functioning rotator cuff.
Your natural shoulder, like an anatomic replacement, has a stationary socket and a moving ball, which only works properly with a functioning rotator cuff. A reverse replacement flips that relationship to a stationary ball and a moving socket, allowing your deltoid muscle to compensate for a rotator cuff that's damaged or no longer working.
This is you if:
- You have shoulder pain that's constant, deep, and doesn't improve with rest
- You've lost range of motion or strength affecting daily activities like reaching, dressing, or sleeping
- You've been told you have shoulder arthritis, rotator cuff tear arthropathy, or an old shoulder injury that's now caught up with you
- Physical therapy, injections, or medication haven't given you lasting relief
- You want an honest assessment of whether you actually need a replacement, and which type is right for you
Symptoms
- Deep, aching shoulder pain that worsens with activity and can disturb sleep
- Stiffness or loss of motion, especially reaching overhead or behind your back
- Grinding, clicking, or catching sensations with movement
- Weakness that makes lifting or reaching difficult
- Pain that persists despite rest, medication, or previous treatment
Causes & Risk Factors
- Osteoarthritis — the most common cause; gradual wear of the joint cartilage over time
- Rotator cuff tear arthropathy — long-standing, untreated rotator cuff tears that lead to joint damage over time
- Rheumatoid arthritis — an autoimmune condition that damages joint cartilage
- Avascular necrosis — loss of blood supply to the bone, causing it to collapse
- Prior shoulder injury, prior shoulder surgery, trauma, or fracture
Non-surgical first.
Many patients with early or moderate arthritis find meaningful relief without surgery. Options include:
- Physical therapy
- Activity modification
- Anti-inflammatory medication
- Anti-inflammatory injections
- Platelet-rich plasma (PRP) injections — using concentrated healing factors from your own blood to help calm inflammation in the joint, without surgery or synthetic medication
I'll always tell you honestly when these options are still likely to help, and when the joint has progressed to the point where replacement is the better path forward.
Shoulder Replacement (Total Shoulder Arthroplasty).
When surgery is the right call, there are two main approaches:
- Anatomic Total Shoulder Replacement (TSA) — recreates your shoulder's natural ball-and-socket structure. Typically the right choice for younger patients and when your rotator cuff tendons are intact and healthy.
- Reverse Total Shoulder Replacement (RTSA) — reverses the ball and socket, shifting the joint's mechanics so your deltoid muscle can compensate. The right choice for patients with damaged or non-functioning rotator cuffs, certain fractures, or a failed prior shoulder surgery. Oftentimes, the older you are, I may recommend a reverse TSA to protect your shoulder from any future injury to your rotator cuff.
Every procedure is performed through a minimally invasive approach designed to protect the surrounding muscle and soft tissue as much as possible, supporting a smoother early recovery.
Recovery & What to Expect
- Sling: 6 weeks, worn at all times except during physical therapy, showering, changing, and while awake at complete rest.
- Physical therapy: Begins around 4 weeks after surgery, once the initial healing phase is complete.
- Follow-up visits: You'll be seen 6 times after surgery, spaced with gradually increasing time between visits over the following year.
- Overall timeline: Recovery is gradual — expect roughly 20% of your improvement in the first 2 months, up to 80% between 2-4 months, and the final stretch through 4-6 months.
Every recovery is different. Dr. Thon will walk you through your personal timeline in detail before and after surgery.
Why Choose Orchard Orthopedics for This
You'll always see Dr. Thon personally for your initial shoulder arthritis evaluation and surgery, not a resident or rotating provider. Every replacement starts with a CT-based 3D surgical plan built from your own anatomy, paired with patient-specific surgical instruments designed around that plan.[1] During surgery, Dr. Thon uses real-time intraoperative guidance to execute that plan with precision, step by step, successfully following the surgical plan with a level of precision difficult to achieve by feel alone.[2] This is some of the most advanced, up-to-date shoulder replacement technology available today, designed to support highly accurate implant positioning, which has been associated with longer-lasting implants and a smoother recovery. That precision, combined with a minimally invasive surgical approach, is paired with the direct access and unhurried follow-up care Orchard Orthopedics is built around.
Patient Story
Build as a sliding/rotating testimonial widget, same carousel pattern as other pages — these three should slide rather than display as a static stacked list.
“Dr Thon was patient and courteous and provided me what time I required to ask all my questions. He even promptly answered my emails over a weekend. I also like the fact he's up to date on all the newest surgical advances in total shoulder replacement, including minimally invasive incisions and stemless implants.”
— Gary, 2023“Dr Thon has been fantastic with my mom's shoulder replacement. Very tricky case with great results. Wonderful bedside manner, great communication, and always on time.”
— Patti, 2024“I had full shoulder reverse surgery. Great procedure with wonderful recovery. I just now, 80 days after surgery, took my first swings with a golf club, and the swing is back. Still need more therapy and still need to build up strength and endurance, but the shoulder is smooth!”
— Tom, 2023Frequently Asked Questions
Understanding Your Injury
Not always. Many patients with early or moderate arthritis get meaningful relief from physical therapy, medication, or injections. Dr. Thon will tell you honestly when those options are still likely to help, and when your joint has progressed to the point where replacement is the better path.
Arthritis tends to progress over time. Left untreated, pain and stiffness typically worsen, and in some cases, an untreated rotator cuff tear alongside arthritis can limit which type of replacement is possible later. An evaluation gives you an honest picture of where you stand.
That's a common turning point. It usually means the joint damage has progressed beyond what an injection can manage, and it's worth discussing whether replacement makes sense for you.
Occasionally, once we're able to fully assess the rotator cuff during surgery, the damage is more extensive than imaging suggested. If that happens, Dr. Thon may need to proceed with a reverse total shoulder replacement instead of an anatomic one, since a reverse replacement doesn't depend on a functioning rotator cuff. He'll explain exactly what was found and why the plan changed, before, during, and after your procedure.
Deciding on Treatment
Anatomic total shoulder replacement recreates your shoulder's natural anatomy: a stationary socket with a moving ball. Like your natural shoulder, an anatomic TSA only works correctly when your rotator cuff tendons are intact, healthy, and functioning properly. Reverse total shoulder replacement flips that relationship — a stationary ball and a rotating socket — which lets your deltoid muscle take over motion that a damaged or irreparable rotator cuff can no longer provide. Dr. Thon will determine which one fits your anatomy and your specific case.
Yes, especially before surgery like this. A second opinion isn't a lack of trust in your first doctor. It's a normal, expected step, and many patients return to their original surgeon with more confidence in the plan either way. It's also worth knowing what your surgical plan actually looks like — Orchard Orthopedics uses CT-based 3D surgical planning and real-time intraoperative navigation, which not every practice offers, so a second opinion here may give you a genuinely different picture of your options.
I have no insurance panel dictating my decisions and no quota to hit. I'll tell you when non-surgical treatment is still realistic for your shoulder as readily as when replacement is the better call.
The decision comes down to the condition of your rotator cuff, the pattern of your joint damage, and your overall anatomy — all of which Dr. Thon evaluates using imaging and, before surgery, a CT-based 3D surgical plan built specifically around your shoulder.
That's a completely normal reaction. Your visit is the place to ask every question you have, including ones about anesthesia, risk, and what the day of surgery actually looks like, until you feel genuinely informed, not just signed up. Appointments at Orchard Orthopedics run longer than a typical practice specifically so we have time to go over everything, with nothing rushed.
Age alone doesn't rule out a replacement. What matters more is your overall health, activity level, and how much the arthritis is limiting your life. We've performed shoulder replacements with great results on patients well into their 80s, and as young as their 30s.
Access & the Orchard Model
No. You can call and schedule directly, no referral or prior authorization required.
You'll always start with Dr. Thon on your initial visit for your shoulder arthritis evaluation and surgery. He remains closely involved in your care throughout.
Surgery & Recovery Logistics
Most patients can be seen same-day or next-day. Call the office and we'll get you scheduled quickly.
Surgery typically takes about 2 hours. Most patients don't need to stay the night and go home the same day. It's rare that an overnight stay is needed, but it's sometimes recommended depending on your health and how you respond after anesthesia.
6 weeks, worn at all times except during physical therapy, showering, changing, and while awake at complete rest.
Most patients can drive within 2-3 weeks once off narcotic pain medication with adequate motion. Return to work depends on your job — desk jobs often resume in 1-2 weeks, while jobs requiring heavy lifting may take longer.
Typically about 6 months. Most patients see roughly 20% of their improvement in the first 2 months, up to 80% by 2-4 months, with the final stretch through 4-6 months. Dr. Thon will walk you through your personal timeline in detail.
Get an honest answer about your shoulder arthritis, and a plan built specifically for you.
Already have a diagnosis or imaging from somewhere else? [ Get a second opinion ]
References
[1] MyShoulder — CT-based preoperative planning and patient-specific instrumentation (medacta.com/GR/myshoulder-patient).
[2] NextAR Shoulder — real-time intraoperative surgical guidance platform (nextar.medacta.com/shoulder).