In cases of advanced osteoarthritis, joint surgery with shoulder prostheses can improve your quality of life.

If all other treatment options for painful shoulder joint wear no longer help, an artificial shoulder joint can be a reliable and effective solution.

The aim of the shoulder prosthesis is to relieve pain and restore mobility to the shoulder – and thus restore a large part of the quality of life .

When and for which conditions is an artificial shoulder joint used?

Joint replacement is considered when severe pain , limited mobility and joint wear have occurred, which can no longer be sufficiently alleviated by other treatments (e.g. physiotherapy, medication or injections) and the level of suffering is high.

Common reasons for using a shoulder prosthesis are:

• Advanced shoulder arthrosis (joint wear) of the shoulder

• Complex fractures of the humeral head

• Rheumatic diseases that damage the joint and cartilage

• Severe rotator cuff damage

• Bone misalignments or fractures that have healed improperly after surgery

Goals of a shoulder prosthesis

The aim of the artificial shoulder joint is to:

• to eliminate pain

• Improve mobility

• Restore everyday skills such as dressing, lifting or combing hair

Precise planning and selection of the right prosthesis are particularly important. Modern technology such as computer-assisted implantation , patient-specific CT data, and even robotics help ensure the shoulder prosthesis fits perfectly and is safe.

What different types are there and when is a shoulder prosthesis necessary?

The shoulder joint is a ball-and-socket joint. The choice of the right shoulder prosthesis depends on the extent of damage to the joint surfaces and whether the rotator cuff is still intact.

1. Partial prosthesis (hemi-prosthesis)

If only the humerus is affected – for example by a fracture or limited arthrosis – and the joint socket (glenoid) is still well preserved, it is often sufficient to replace a hemiprosthesis, i.e. only the humeral head .

To do this, the damaged joint surface of the humerus is removed and replaced with a so-called stemless surface prosthesis . The natural bone is largely preserved, making it particularly gentle.

If desired or necessary, the pan can also be replaced.

2. Total shoulder replacement

If both the shoulder head and the socket on the shoulder blade are severely damaged by osteoarthritis or injury, a complete endoprosthesis is necessary.

This involves:

• the humeral head is replaced by a short metal shaft

• the socket is replaced by a plastic implant (made of polyethylene)

The socket is anchored either cementlessly (e.g., through bone growth) or with bone cement . There are different types of sockets, including:

• Pans with tenon anchoring

• Pans with keel anchoring

• Titanium pans with plastic insert that can be converted into another system if required

Modern technology: Navigation and computer-assisted implantation from the shoulder prosthesis specialist

Modern shoulder prostheses are often made using:

• Patient-specific CT data

• Computer-aided planning

• navigation systems

• and in some centers also with robotic support

The goal is to achieve millimeter-precise placement of the implant – for better mobility, less wear, and a longer lifespan of the prosthesis.

A precisely positioned artificial joint significantly improves the outcome and ensures greater patient satisfaction.

Inverse shoulder prosthesis – the solution for tendon damage

In some cases, not only is the joint worn out, but the important rotator cuff – the muscle group that stabilizes and moves the shoulder joint – is so badly damaged that it can no longer fulfill its function.

In this case, an anatomical prosthesis is usually not a good choice, as shoulder mobility and pain in the shoulder cannot be reliably restored after an artificial joint replacement.

A special form of artificial shoulder joint is used here to reduce pain and improve mobility: the inverse (reverse) shoulder prosthesis .

Importance and success of the reverse shoulder prosthesis

What does "inverted" prosthesis mean?

In a normal (anatomical) shoulder prosthesis, the ball sits on the upper arm and the socket sits on the shoulder side – just like in natural anatomy.

With the inverse prosthesis it is exactly the opposite :

• The ball is attached to the shoulder socket

• The glenoid acetabulum is located on the humerus

Advantage of the reversed technique:

By reversing the joint mechanics, the center of rotation is shifted during the procedure so that the deltoid muscle can partially take over the function of the rotator cuff .

This makes it possible to actively lift the arm again , even if the tendons are torn.

The inverse shoulder prosthesis is usually used for:

• Patients over 65 years of age

• with severe rotator cuff damage

• and good deltoid muscle function .

Materials of the anatomical and inverse endoprosthesis

Artificial shoulder joints are made of biocompatible materials that ensure long durability and good tolerability:

• Metal components mostly made of titanium or cobalt-chromium alloys

• Sliding surfaces made of polyethylene (PE) – a special, durable plastic

• Cemented or cementless anchorage , depending on bone quality

In most cases, short-stem implants are designed to be replaced or adapted later if necessary (e.g., conversion to an inverse system).

Follow-up treatment and rehabilitation after a shoulder endoprosthesis was implanted in the clinic.

The implantation of a synthetic shoulder joint is an important step on the way to less pain and better mobility – but the right aftercare is just as crucial for long-term success.

Immediately after the operation

After the surgery, the arm is initially immobilized in a shoulder brace . This is usually worn for a few days to a few weeks, depending on the type of prosthesis and the course of the surgery. Pain medication and targeted positioning help alleviate initial discomfort.

Early mobilization

Early functional physiotherapy, under the guidance of experienced therapists, usually begins the day after surgery. The goal is to gradually regain shoulder mobility over the first six weeks—without jeopardizing the healing process.

rehabilitation

Depending on the individual findings and mobility restrictions prior to the procedure , inpatient or outpatient rehabilitation may be provided. This includes:

• Mobility, strength and muscles systematically built up

• Avoid protective postures

• Everyday functions are specifically trained

The rehabilitation usually lasts 3 weeks and is individually tailored to the patient.

Healing process

Full recovery can take several months. Patience and regular exercise are crucial for a good outcome. Many patients report a noticeable improvement in shoulder function and a more pain-free daily life after rehabilitation.

How long does a shoulder prosthesis last after surgery?

Modern implants are durable. The average lifespan is:

• 10 to 20 years , often longer

• Depending on load , implant type and individual factors

If wear, loosening or infection occurs again after many years, the prosthesis can usually be revised (replaced) .

Conclusion: An artificial shoulder joint can restore quality of life

A new shoulder joint is a proven and effective way to relieve pain and regain mobility when other therapies are no longer sufficient.

Thanks to modern technology, individual implant selection and gentle surgical procedures, many patients today benefit from significantly improved well-being – in everyday life, during leisure activities and even in sports.

The decision to have a shoulder prosthesis should always be made in close consultation with the treating physician – taking into account the individual complaints, wishes and living circumstances.