Dr Puah Ken Lee 潘健理
Orthopaedic Surgeon
Shoulder, Elbow & Sports Injuries
Practising at Mount Elizabeth Novena Hospital, Singapore
Appointments by prior arrangement
Dr Puah Ken Lee 潘健理
Orthopaedic Surgeon
Shoulder, Elbow & Sports Injuries
Mount Elizabeth Novena Hospital, Singapore
✔ Subspecialty Focus in Shoulder & Elbow, Sports Injuries
✔ Practising at Mount Elizabeth Novena Hospital
✔ Evidence-based treatment, Individualised Care
Shoulder Replacement
Shoulder replacement, also known as shoulder arthroplasty, is a surgical procedure used to treat severe shoulder arthritis and certain complex shoulder conditions when pain and loss of function have not improved with non-surgical treatment.
During the operation, damaged joint surfaces are replaced with artificial implants designed to restore smoother movement, relieve pain and improve shoulder function.
Not every patient with shoulder arthritis requires shoulder replacement. Surgery is considered only when symptoms significantly affect daily activities or quality of life despite appropriate non-surgical management.
When is Shoulder Replacement Recommended?
Shoulder replacement may be considered for patients with:
- Advanced shoulder arthritis
- Persistent pain despite non-surgical treatment
- Severe loss of shoulder movement
- Advanced rotator cuff arthropathy
- Selected complex fractures of the upper arm (proximal humerus)
- Failed previous shoulder surgery in selected cases
The decision depends on your symptoms, examination findings, imaging and functional goals.
Shoulder replacement removes damaged joint surfaces and replaces them with artificial components to improve pain and function.
Types of Shoulder Replacement
Several different types of shoulder replacement are available.
The most appropriate option depends on the condition of your shoulder, particularly the rotator cuff.
Anatomic Total Shoulder Replacement
An anatomic shoulder replacement reproduces the normal anatomy of the shoulder.
The damaged ball is replaced with a metal component, while the socket is resurfaced with a polyethylene component.
This procedure is usually suitable for patients who have:
- Advanced shoulder arthritis
- An intact rotator cuff
Reverse Shoulder Replacement
In a reverse shoulder replacement, the normal ball-and-socket relationship is reversed.
This design allows the deltoid muscle to compensate when the rotator cuff is no longer functioning adequately.
It is commonly recommended for:
- Rotator cuff arthropathy
- Massive irreparable rotator cuff tears
- Selected complex fractures
- Revision shoulder replacement
Hemiarthroplasty
A hemiarthroplasty replaces only the humeral head.
Today, it is performed less commonly because total and reverse shoulder replacements often provide more predictable outcomes for many conditions.
It may still be appropriate in selected situations.
Comparison of 3 types of Shoulder Replacement
| Feature | Anatomic Total Shoulder | Reverse Shoulder | Hemiarthroplasty |
|---|---|---|---|
| Rotator cuff required | ✔ Yes | ✘ No | Usually yes |
| Typical indication | Primary osteoarthritis | Rotator cuff arthropathy, complex fractures | Selected fractures or specific indications |
| Components replaced | Ball and socket | Ball and socket (reversed configuration) | Ball only |
Anatomic vs. Reverse Shoulder Replacement
| Anatomic Shoulder Replacement | Reverse Shoulder Replacement |
|---|---|
| Preserves normal anatomy | Ball-and-socket configuration reversed |
| Requires a functioning rotator cuff | Suitable when the rotator cuff is deficient |
| Commonly used for primary osteoarthritis | Commonly used for rotator cuff arthropathy |
| Movement powered by the rotator cuff and deltoid | Movement relies more on the deltoid muscle |
Conditions Treated with Shoulder Replacement
Shoulder replacement may be performed for:
- Shoulder arthritis
- Rotator cuff arthropathy
- Complex proximal humerus fractures
- Selected revision procedures
How is Shoulder Replacement Performed?
During surgery:
- Damaged cartilage is removed.
- The humeral head is prepared for the implant.
- The socket is resurfaced when appropriate.
- Artificial components are inserted.
- Stability and movement are assessed before the wound is closed.
The procedure is performed under anaesthesia, often with additional regional pain control to improve comfort after surgery.
What Are the Benefits?
Potential benefits include:
- Relief of shoulder pain
- Improved shoulder movement
- Better sleep
- Improved quality of life
- Increased ability to perform daily activities
The degree of improvement varies depending on the underlying diagnosis and the condition of the surrounding muscles and tendons.
Risks
As with any major joint replacement, potential risks include:
- Infection
- Bleeding
- Stiffness
- Dislocation
- Implant loosening over time
- Nerve injury (uncommon)
- Fracture
- Need for revision surgery
These risks are discussed during the consultation and considered alongside the expected benefits.
Recovery After Shoulder Replacement
Recovery is gradual and involves physiotherapy.
First 6 Weeks
- Sling
- Gentle shoulder exercises
- Protection of the repair
6–12 Weeks
- Gradual increase in movement
- Light daily activities
- Physiotherapy progression
3–6 Months
- Progressive strengthening
- Functional recovery
- Return to recreational activities
Many patients continue to notice improvements for up to a year after surgery.
Recovery Timeline
| Activity | Approximate Time |
|---|---|
| Sling | 3–6 weeks |
| Desk work | 2–4 weeks |
| Driving | 6–8 weeks |
| Physiotherapy | Begins early |
| Strengthening | Around 12 weeks |
| Functional recovery | 3–6 months |
| Continued improvement | Up to 12 months |
Frequently Asked Questions
Will I regain full shoulder movement?
The goal of shoulder replacement is to reduce pain and improve function. While many patients regain excellent movement, the final range of motion depends on factors such as the underlying diagnosis, muscle function and adherence to rehabilitation.
How long does a shoulder replacement last?
Modern shoulder replacements are designed to provide many years of function. Longevity varies depending on factors such as age, activity level, implant type and overall shoulder health.
What is the difference between total and reverse shoulder replacement?
An anatomic total shoulder replacement preserves the normal anatomy and requires a healthy rotator cuff. A reverse shoulder replacement changes the position of the ball and socket, allowing the deltoid muscle to compensate when the rotator cuff is no longer functioning adequately.
Will I need physiotherapy?
Yes. Physiotherapy is an important part of recovery and helps restore movement, strength and shoulder function after surgery.
Why Choose Dr Puah Ken Lee?
Dr Puah Ken Lee is an orthopaedic surgeon in Singapore whose practice focuses on shoulder, elbow and sports injuries. He believes that shoulder replacement should be recommended only when appropriate non-surgical treatments are no longer providing satisfactory relief. Every patient undergoes a detailed assessment to determine the most suitable treatment, with careful consideration given to symptoms, imaging findings, rotator cuff function and long-term goals.
Related Pages
Conditions
- Shoulder Arthritis
- AC Joint Arthritis
- Rotator Cuff Tear
- Rotator Cuff Arthropathy
- Proximal Humerus Fracture
Treatments
- First Orthopaedic Consultation
- Shoulder Surgery
- Non-surgical Treatment
- Ultrasound-guided Shoulder Injections
For a full overview of shoulder conditions, visit Shoulder Specialist Singapore
Dr Puah is regularly invited to teach shoulder surgery internationally
Specialist Care for Shoulder Injuries in Singapore
Dr Puah is an orthopaedic surgeon specialising in shoulder, elbow and sports injuries. He provides personalised care tailored to each patient’s condition and activity level.
Consultations are available at Mount Elizabeth Novena.
If you are experiencing shoulder pain that is affecting your daily life or sports, early assessment can help guide appropriate treatment.
Book a consultation or contact the clinic to discuss your condition.
Book a Consultation
Book a consultation or contact the clinic via WhatsApp to get started
Book a consultation at 360 Orthopaedics, Mount Elizabeth Novena
Shoulder arthritis is treatable. Early diagnosis and appropriate management can improve outcomes and prevent long-term problems.
Dr Puah Ken Lee is an orthopaedic surgeon in Singapore specialising in shoulder, elbow and sports injuries at 360 Orthopaedics, Mount Elizabeth Novena. Patients with persistent shoulder pain and stiffness are encouraged to seek specialist evaluation.