Total shoulder replacement is an operation in which both worn surfaces of the shoulder joint - the ball at the upper end of the arm bone and the socket - are replaced with artificial parts. It is used mainly for severe arthritis of the shoulder when the rotator cuff tendons are working, and when pain and stiffness limit daily life despite other treatments.
This page describes anatomic total shoulder replacement, in which the ball and socket are replaced in their natural arrangement. When the rotator cuff is badly torn, a reverse shoulder replacement is usually considered instead; it is described on the main shoulder replacement page.
PMG Hospital (PMG Orthopedic Hospital), Gota, is an orthopedic hospital for total shoulder replacement in Ahmedabad. This page explains who may need the operation, how it is done, implant choices, replacement of both shoulders, recovery, risks and cost factors.
What Is Total Shoulder Replacement?
In an anatomic total shoulder replacement (total shoulder arthroplasty), the damaged ball (humeral head) is removed and replaced with a smooth metal ball, fixed either on a stem in the arm bone or on a shorter stemless base. The worn socket (glenoid) is resurfaced with a plastic component. Together, these parts allow the shoulder to move smoothly.
This design relies on the rotator cuff to keep the ball centred in the socket and to help move the arm. For this reason, the rotator cuff must be working, or have only a small tear that can be repaired, for an anatomic total replacement to be suitable.
Who May Need Total Shoulder Replacement?
Total shoulder replacement is usually considered for severe shoulder pain and stiffness that limit daily life and no longer respond to medicines, physiotherapy or injections, when X-rays show that both the ball and the socket are damaged. Common causes include:
- Osteoarthritis of the shoulder
- Rheumatoid arthritis and other inflammatory arthritis, when the rotator cuff is working
- Arthritis after an injury, such as an earlier fracture or dislocations
- Avascular necrosis (osteonecrosis) of the ball when the socket has also become damaged
Enough healthy bone in the socket is also needed to hold the plastic component. When the rotator cuff is badly torn, or the socket bone is too worn, a reverse shoulder replacement may be more suitable.
Treatment Before Surgery
Surgery is usually advised only after other treatments have been tried, such as changes to daily activities, physiotherapy, pain-relief medicines used as advised by a doctor, and steroid injections in selected patients. A total shoulder replacement treatment hospital should provide these non-surgical treatments as well as surgery, because not every painful shoulder needs an operation. Tell the surgeon about any recent shoulder injection; a steroid injection within about three months before a replacement may increase the risk of infection.
Total vs Partial Shoulder Replacement
| Total shoulder replacement | Partial shoulder replacement (hemiarthroplasty) | |
|---|---|---|
| What is replaced | Both the ball and the socket | Only the ball |
| Parts used | Metal ball on a stem or stemless base, and a plastic socket component | Metal ball on a stem, or a metal cap over the ball (resurfacing); the natural socket is kept |
| Usually considered for | Arthritis affecting both the ball and the socket, with a working rotator cuff | Damage limited to the ball with a healthy socket, such as avascular necrosis, some fractures and selected younger patients |
The choice depends on the condition of the socket, the rotator cuff and the bone, which the surgeon assesses with examination and scans.
Related pages: Shoulder replacement·Partial shoulder replacement·Revision shoulder replacement·Rotator cuff repair
Assessment Before Surgery
A total shoulder replacement doctor in Ahmedabad - an orthopaedic surgeon - assesses the shoulder before advising surgery:
- 1History and examination: pain, movement, strength of the rotator cuff, nerve function, and the neck, which can also cause pain felt around the shoulder
- 2X-rays of the shoulder: to see the joint and the shape of the socket
- 3CT scan: often used to assess wear and bone of the socket and to plan the position of the socket component
- 4MRI or ultrasound: in selected cases, to assess the rotator cuff tendons
- 5Fitness for surgery: blood tests, ECG, blood sugar and blood pressure control, and checks of the heart, lungs and kidneys as needed
- 6Infection check: any skin, dental or urinary infection is treated before surgery
- 7Medicines: blood thinners and some other medicines may need to be stopped or changed, only as advised by the doctor
Total Shoulder Replacement Surgery in Ahmedabad: Step by Step
The main steps are similar in any total shoulder replacement surgery hospital in Ahmedabad:
- 1Anaesthesia: usually general anaesthesia, often with a nerve block in the neck that numbs the shoulder and arm for pain relief after surgery
- 2Approach: a cut is made over the front of the shoulder, and the subscapularis tendon (a rotator cuff tendon at the front) is usually detached, or released with a small piece of bone, to reach the joint
- 3Preparing the bone: the damaged ball is removed, and the socket is shaped to receive the plastic component
- 4Fitting the implant: the plastic socket component is fixed, usually with bone cement; the metal ball is fitted on a stem or stemless base, with or without bone cement; movement and stability are checked
- 5Repair and closure: the subscapularis tendon (or the piece of bone) is repaired, the skin is closed and dressed, and the arm is placed in a sling
- 6Duration: the operation usually takes about two hours
Implant and Fixation Choices
| Stemmed implant | Stemless implant | |
|---|---|---|
| Design | A stem fits into the shaft of the arm bone | A short base is fixed in the upper end of the arm bone, without a long stem |
| Usually suitable for | Most shoulders, including those with weaker bone | Shoulders with good bone quality |
| Points to consider | The longest follow-up | Keeps more of the natural bone; longer-term information is still being collected |
On the socket side, the plastic component is usually fixed with bone cement; some designs are fixed without cement. Correct position of the socket component matters for how long the replacement lasts, so it is planned with X-rays and, in many cases, a CT scan.
Can Both Shoulders Be Replaced at the Same Time?
| Both shoulders in one operation | One shoulder at a time (staged) | |
|---|---|---|
| How it is done | Both shoulders are replaced under the same anaesthetic | Each shoulder is replaced separately, usually several months apart |
| Daily life during recovery | Very difficult, because both arms are limited at the same time | One arm can be used during recovery |
| Points to consider | Longer operation and possibly higher risk; rarely advised | The usual approach |
The decision depends on general health and how much each shoulder is affected.
Recovery After Total Shoulder Replacement
| Time | What usually happens |
|---|---|
| First few days | Hospital stay (usually one to three days); arm in a sling; pain control; hand, wrist and elbow exercises; discharge when safe |
| Weeks 1–6 | Sling worn as advised (often about four to six weeks); gentle shoulder exercises as taught by the physiotherapist; stitches or staples removed at about two weeks, once the wound has healed |
| After the sling is stopped (about 4–8 weeks) | More active movement exercises; light daily tasks; driving only once the surgeon allows it and arm control is good |
| 3–6 months | Strengthening exercises; most daily activities |
| Up to a year | Strength and range of movement continue to improve |
This is a general guide, and recovery differs from person to person. The subscapularis tendon that was repaired during surgery needs time to heal, so movements are increased step by step as advised by the surgeon and physiotherapist.
Care After Surgery
- Wear the sling as advised, including at night in the early weeks
- Until the surgeon allows it, do not lift heavy objects, push yourself up from a chair or bed with the operated arm, or force the arm outward or behind your back
- Do the exercises taught by the physiotherapist every day; they are a key part of recovery
- Keep the wound clean and dry until it has healed
- Attend follow-up visits, including X-rays as advised
How Long Does a Total Shoulder Replacement Last?
A large study of published case series and a national joint registry found that more than nine in ten anatomic total shoulder replacements had not needed revision surgery 10 years after the operation. Information on longer periods is limited. How long an implant lasts depends on age, activity level, bone quality, the condition of the rotator cuff and the position of the components. Over time, the socket component can loosen or wear, or the rotator cuff can tear, and further surgery may then be needed. Regular follow-up visits help to detect problems early.
Source: Evans JP et al. The Lancet Rheumatology. 2020;2:e539–e548.
Risks and Possible Complications
Total shoulder replacement is a common operation, but no surgery is without risk. The surgeon explains these risks before taking consent.
- Infection of the wound or around the implant, which may need further surgery; infection can appear months or years later, sometimes only as increasing pain or stiffness without fever
- Instability or dislocation of the new joint
- Injury to nerves (such as the axillary nerve) or blood vessels, which is uncommon; nerve problems are often temporary
- Fracture of the arm bone or shoulder blade during or after surgery
- Stiffness or limited movement, especially when exercises cannot be continued
- Loosening or wear of the implant over time, which may need revision surgery
- Blood clots in the arm or leg veins or lungs, which are less common than after hip or knee replacement
- Continuing pain or weakness in some patients
- Anaesthesia-related and general medical risks, including temporary numbness of the arm after a nerve block; the nerve block in the neck can also weaken the breathing muscle on that side for some hours, so tell the anaesthetist if you have lung disease; and heart, lung or kidney problems, especially in older patients or those with other illnesses
- Failure of the repaired subscapularis tendon to heal, which can cause weakness or instability
- A later tear of the rotator cuff, which can affect function and may need further surgery
- Socket component problems: loosening or wear of the plastic socket component is one of the most common long-term reasons for revision of an anatomic total shoulder replacement
Total Shoulder Replacement Surgery Hospital in Ahmedabad
When choosing a total shoulder replacement hospital in Ahmedabad, check that the treating surgeon is a qualified orthopaedic surgeon with valid medical council registration, that the hospital regularly performs this operation, how infection is prevented, which implants and tests are available, what physiotherapy and follow-up are provided, and what the written estimate includes.
Total Shoulder Replacement Surgery Cost in Ahmedabad
- The implant chosen (stemmed or stemless) and how it is fixed
- One shoulder or both shoulders
- Length of hospital stay and room category
- Other medical conditions and any extra care needed
- Physiotherapy and follow-up
A written, itemised estimate can be requested from the hospital after assessment.
Insurance
- Medically necessary shoulder replacement is generally covered under health insurance policies, subject to policy terms, waiting periods and insurer approval
- Some policies have limits on room rent or implant costs; check these with your insurer before surgery
- Ask the hospital whether cashless treatment is available with your insurer, and which documents are needed
Total Shoulder Replacement Doctor in Ahmedabad
Total shoulder replacement is planned and performed by an orthopaedic surgeon who works in shoulder surgery and joint replacement. A family doctor may treat the shoulder pain first, and other doctors and therapists help before and after the operation:
| Doctor or team member | Role in total shoulder replacement |
|---|---|
| Family physician | Treats early shoulder pain; refers to an orthopaedic surgeon when pain and stiffness persist despite treatment |
| Orthopaedic surgeon (shoulder and joint replacement) | Assesses the joint and the rotator cuff, advises non-surgical treatment or the type of replacement, performs the operation and leads follow-up |
| Radiologist | Reports the X-rays and CT scan of the socket, and the MRI or ultrasound of the rotator cuff when needed |
| Anaesthetist | Checks fitness for surgery and gives general anaesthesia and the nerve block for pain relief |
| Physician or cardiologist | Assesses and helps control diabetes, blood pressure, heart or lung conditions before surgery |
| Physiotherapist | Guides sling use and step-by-step shoulder exercises over the months of recovery |
Total Shoulder Replacement Surgery Doctor in Ahmedabad
Before agreeing to the operation, it is reasonable to ask your total shoulder replacement surgery doctor in Ahmedabad a few clear questions. The answers help you understand the plan for your shoulder and give informed consent.
- What did the scans show about my rotator cuff and the bone of the socket?
- Will a CT scan be used to plan the position of the socket component?
- How will the tendon at the front of the shoulder be detached and repaired, and how long will it take to heal?
- Will a nerve block be used for pain relief, and does any lung condition I have affect this?
- If I have had a steroid injection in the shoulder recently, does this change the timing of surgery?
- When can I start using the arm for eating, dressing and writing?
- When can I expect to drive and return to work?
- Whom should I contact after discharge if I have fever, wound discharge or new numbness in the hand?
Orthopedic Hospital for Total Shoulder Replacement in Ahmedabad
The hospital where a total shoulder replacement is done should be able to plan the operation with scans, operate under strict infection control and support a long period of physiotherapy. These are the facilities that matter most:
| Facility | Why it matters |
|---|---|
| Operation theatre suitable for joint replacement, with strict infection-control practices | Infection around an implant is a serious complication |
| Anaesthesia services, including nerve blocks | Needed for general anaesthesia and pain relief after surgery |
| X-ray and access to CT and MRI scans | Needed to assess the socket and rotator cuff and to plan the implant position |
| Laboratory tests and blood transfusion support | Needed for pre-operative checks and in case of blood loss |
| Access to intensive care for high-risk patients | Older patients and those with heart or lung disease may need closer monitoring |
| Physiotherapy | Recovery depends on supervised exercises over several months |
| Follow-up with X-rays | Regular checks help to detect loosening, wear or a later rotator cuff tear early |
The facilities available at PMG Hospital are listed further below on this page.
Treating Surgeon
At PMG Hospital, total shoulder replacement is performed by:
| Detail | Information |
|---|---|
| Name | Dr. Hiren Patel |
| Qualification | MS (Ortho), B.J. Medical College, Ahmedabad |
| Specialty | Orthopaedics |
| Designation | Director & Head Joint Replacement Surgeon, PMG Hospital |
| Registration status | Registered Medical Practitioner |
| Registration number | Gujarat Medical Council Reg. No. G-20583 |
| OPD availability | Monday to Saturday, 10:00 AM - 8:00 PM |
Facilities at PMG Hospital
- Orthopaedic OPD, Monday to Saturday
- Emergency and trauma care, 24×7
- Orthopaedic physiotherapy centre
Frequently Asked Questions
When should I see a doctor about total shoulder replacement?
See an orthopaedic surgeon if shoulder pain limits reaching, lifting, dressing or sleeping, if the shoulder is stiff, or if medicines, injections and physiotherapy no longer help. The surgeon examines the shoulder and looks at the X-rays and scans to decide whether a total shoulder replacement, another type of replacement or continued non-surgical treatment is suitable.
What is total shoulder replacement?
Total shoulder replacement replaces both the ball (the upper end of the arm bone) and the socket of the shoulder in their natural arrangement: a metal ball fixed on a stem or a stemless base, and a plastic socket component. Because it depends on the rotator cuff tendons to move and stabilise the shoulder, it is used when the rotator cuff is working.
What if my rotator cuff is torn?
A small tear may be repaired at the time of surgery. If the rotator cuff is badly torn and cannot be repaired, an anatomic total shoulder replacement is more likely to become unstable or loosen early, and a reverse shoulder replacement is usually considered instead. The rotator cuff is assessed with examination and scans before surgery and checked during the operation.
What is the difference between stemmed and stemless implants?
A stemmed implant has a stem that fits into the arm bone and has the longest follow-up. A stemless implant is fixed in the upper end of the arm bone without a long stem, keeps more of the natural bone and needs good bone quality. The surgeon chooses based on bone quality, anatomy and the condition of the shoulder.
Can both shoulders be replaced at the same time?
It is possible but uncommon, because recovering with both arms limited at the same time makes daily tasks very difficult, and a longer operation can carry more risk. Most patients have one shoulder replaced at a time, several months apart, so that one arm can be used during recovery.
What precautions should I take after total shoulder replacement?
For the first several weeks, the arm is kept in a sling as advised, and you should avoid lifting, pushing yourself up with the operated arm, and turning the arm outward beyond the limit set by the surgeon, to protect the repaired tendon at the front of the shoulder. The physiotherapist explains which movements are allowed and when.
How long does a total shoulder replacement last?
A large study of published case series and a national joint registry found that more than nine in ten anatomic total shoulder replacements had not needed revision surgery 10 years after the operation. Information on longer periods is limited. Over time, the socket component can loosen or wear, and further surgery may then be needed.
What facilities should a hospital have for total shoulder replacement?
It should have an operation theatre suitable for joint replacement with strict infection-control practices, anaesthesia services, X-ray and access to CT and MRI scans, laboratory tests, blood transfusion support, physiotherapy, access to intensive care for high-risk patients, and arrangements for follow-up.
What decides the cost of total shoulder replacement?
The cost depends on the implant (stemmed or stemless) and how it is fixed, one shoulder or both, the length of hospital stay, room category, other medical conditions and physiotherapy. A written, itemised estimate can be requested from the hospital after assessment.
Contact and Location
PMG Hospital
3rd Floor, Athena Avenue, B/H Jaguar Showroom, Nr. Eulogia Inn Hotel, Gota, Ahmedabad, India
- Phone / WhatsApp:
- +91 96627 70141
- OPD:
- Mon – Sat · 10:00 AM – 8:00 PM
- Emergency and trauma care:
- 24×7