Shoulder Replacement

Anatomic replacement replicates normal shoulder anatomy (ball on humerus, socket on scapula) and requires an intact rotator cuff for stability. Reverse replacement switches the ball and socket positions, allowing the deltoid muscle to power the arm when the rotator cuff is torn or deficient. Reverse replacement now accounts for approximately 75% of all shoulder replacements in the US and is increasingly used for elderly patients and those with cuff tear arthropathy. Your surgeon will recommend the appropriate type based on rotator cuff condition and bone quality.

Most patients regain functional range of motion with 120-150 degrees of forward elevation, sufficient for overhead activities, dressing, and reaching. Published studies show ASES scores improve from 35 to 74 on average. Reverse replacement provides reliable overhead reach with approximately 52 degrees of forward elevation improvement, though external rotation improvement may be more modest. Results depend on pre-operative stiffness, muscle quality, and rehabilitation compliance. Individual outcomes may vary.

Low-impact activities including swimming, golf, doubles tennis, and cycling are generally considered safe after full recovery, typically at 4-6 months. Studies show recreational activities resume at an average of 17 weeks post-surgery. Overhead sports and contact sports are typically discouraged as they may accelerate implant wear. Published data shows 94% of patients at 10+ years would have the procedure again. Your surgeon will provide personalized activity guidelines based on your implant type and recovery progress.

Based on a Lancet Rheumatology meta-analysis of 7,779 replacements, anatomic total shoulder arthroplasty shows 94.2% survival at 5 years and 90.2% at 10 years. Overall, approximately 90% of all shoulder replacements last at least 10 years. For younger patients under 65, 20-year survival is approximately 60%, with glenoid component loosening being the primary cause of revision. Individual implant longevity depends on activity level, implant type, bone quality, and rehabilitation compliance.

Reverse replacement often allows earlier active motion since it does not rely on the rotator cuff, but may have more initial restrictions on external rotation exercises. Anatomic replacement requires strict protection of the subscapularis repair for 6 weeks. Overall recovery timelines are similar: sling for 4-6 weeks, active range of motion at 6-12 weeks, strengthening at 3-4 months, and full recovery at 6-12 months. Your surgical team will provide specific rehabilitation protocols based on your procedure type.

For short-haul flights under 2 hours, a minimum of 2 weeks post-surgery is generally recommended. For long-haul flights over 4 hours, 4-6 weeks is the standard recommendation. DVT prevention measures are essential including aspirin (as directed by physician), compression stockings, regular movement, and adequate hydration. Your implant will trigger airport metal detectors, so carry your implant identification card. Individual timelines may vary based on recovery progress and surgeon assessment.

A minimum stay of 3-4 weeks is recommended, comprising 2-3 days for pre-operative consultations and imaging, 2-4 nights hospitalized, and 10-14 days for wound monitoring, suture removal, and early physical therapy. This allows for the first follow-up and wound check at 2 weeks post-surgery. Extended stays provide direct access to the surgical team for any early complications. Telemedicine follow-up is available for continued coordination after departure.

Thai hospitals offer all five types of shoulder replacement: anatomic total shoulder replacement, reverse total shoulder arthroplasty, hemiarthroplasty (partial replacement), stemless arthroplasty (bone-preserving), and resurfacing hemiarthroplasty. Multiple implant systems are available from major manufacturers including Zimmer Biomet, DePuy Synthes, Exactech, and Stryker. Vejthani Hospital explicitly offers all five types with CCPC orthopedic program accreditation, while BNH Hospital operates Thailand's first dedicated Shoulder and Joint Centre.