Total Shoulder Replacement Surgery: What You Need to Know

Total shoulder replacement surgery is a common surgical procedure for individuals suffering from severe shoulder arthritis or injury. This surgery involves replacing the damaged shoulder joint with an artificial implant to relieve pain and restore function. This comprehensive guide will help you understand total shoulder replacement surgery, including pre-surgery preparation, what to expect on the day of surgery, and post-surgery recovery.

Your procedure may be a traditional “primary” shoulder replacement or a “reverse” shoulder replacement depending on the condition of your rotator cuff. Dr Tauro will discuss this with you in detail before your surgery.

About the Author: Joseph Tauro, MD, a Board-Certified orthopedic surgeon, is nationally recognized for his expertise in treating shoulder, sports, and degenerative joint disorders. As a professor at Rutgers Medical School and a Master Instructor for the Arthroscopy Association of North America (AANA), he leads the field in developing new techniques for minimally invasive joint replacement, arthroscopic shoulder surgery, and Augmented Reality surgical training. Patients from across the U.S. are referred to Dr. Tauro for his specialized care. Request an appointment with Dr. Tauro today to experience expert orthopedic care first-hand!


Illustration showing total shoulder replacement surgery procedures - reverse shoulder arthroplasty and total shoulder arthroplasty


Pre-Surgery Guidelines for Total Shoulder Replacement

What You Should Do Before Shoulder Replacement Surgery:

Consultation with Dr. Tauro:

  • Have a thorough discussion with your surgeon about the procedure, risks, and benefits of total shoulder replacement surgery.
  • Dr Tauro uses pre operative computerized planning for almost all of the shoulder replacements he performs. This may involve the production of a custom guide to be used during your surgery or the use of a camera guided system in the operating room. This greatly improves the accuracy of your surgery. You will need to go for a specialized CT scan of your shoulder at least 6 weeks before your surgery to allow the use of this technology.

Medical Clearance and Preparation:

  • Obtain medical clearance from your primary care physician if required.
  • Review all medications with your doctor. You may need to stop certain medications, like blood thinners, a few days before surgery.

Physical and Home Preparation:

  • Engage in pre-surgery physical therapy or a home therapy program if recommended to strengthen the shoulder muscles before shoulder replacement surgery.
  • Arrange your home to accommodate your post-surgery needs. This might include setting up a comfortable resting area and ensuring easy access to necessities. You may need assistance with daily activities for the first few days after surgery.
  • Most patients feel more comfortable sleeping partly sitting up after their surgery for up to 6 weeks. We recommend that you use a reading pillow with a few regular pillows in front of it for sleep. These are commercially available online or from stores such as Target or Walmart.

What You Shouldn’t Do Before Shoulder Replacement Surgery:

Eating and Drinking:

  • Do not eat or drink anything after midnight before your shoulder surgery day. This includes chewing gum, which can produce excessive saliva in your stomach.

Smoking and Alcohol:

  • Avoid smoking as it can impair healing and increase the risk of complications.
  • Do not consume alcohol at least 24 hours before shoulder replacement surgery.


Elderly man is stretching his shoulder before exercising in the park outside. Man has recovered from a successful total shoulder replacement surgery.


Day of Total Shoulder Replacement Surgery

What to Do on the Day of Surgery:

Arrive on Time:

  • Arrive at the hospital or surgical center at the scheduled time. The surgery center will call you with that time generally the day before your shoulder replacement surgery.

Wear Comfortable Clothing:

  • Wear loose, comfortable clothing that is easy to remove and put on. Button-up or zip-up tops are recommended.

Bring Essentials:

  • Bring necessary documents and a list of medications.

What to Expect on the Day of Surgery:

Pre-operative Preparation:

  • You will undergo pre-operative preparations, including vital sign checks and anesthesia administration. Anesthesia will usually include a regional block to numb the shoulder and general anesthesia.

Surgery Duration:

  • The procedure typically takes 1-2 hours, but this can vary depending on the complexity of the shoulder replacement surgery.

Post-Operative Recovery:

  • After surgery, you will be monitored in a recovery area until the anesthesia wears off.

Post-Operative Care and Recovery After Total Shoulder Replacement

Immediate Post-Op Care:

  • Almost all shoulder replacements are considered outpatient procedures. You usually go home the same day or we may keep you overnight if your operation is more complex or you have a medical condition we need to monitor overnight. Regardless, we will have you out of bed and in a chair the day of surgery and walking the same day or the morning after the surgery.
  • We DO NOT send patients to inpatient rehabilitation facilities as we feel infection rates are higher and care is inconsistent. You are much better off at home in a clean, comfortable and familiar environment.
  • You will need to make sure a friend or family member is with you for the first 2 days after discharge.
  • We will prescribe outpatient physical therapy to do at home. You should begin therapy immediately, usually 2-5 days after your surgery

Pain Management:

  • Expect some pain and discomfort, which will be managed with prescribed medications. With the regional block, there is usually minimal pain initially, which can be managed with Tylenol and ibuprofen afterward. When the block wears off a few days after surgery, pain may increase and you may need stronger pain medication which we will prescribe. Make sure the hospital or surgery center has accurate information about your pharmacy.

Sling Usage:

  • Your shoulder will be immobilized in a sling to protect the repaired area.

Follow-Up Appointments:

  • Schedule follow-up appointments with your surgeon, usually 1 to 2 weeks post-surgery. You can pre-schedule this appointment in our office before your shoulder replacement surgery.


Active and fit middle-aged woman training in gym, performing weight lifting exercises. She has recovered from a successful total shoulder replacement surgery.


Phases of Recovery After Total Shoulder Replacement Surgery:

Phase 1 (0-2 Weeks): Protection and Initial Healing

  • Wear the sling as directed.
  • Engage in passive motion exercises as prescribed by your physical therapist.
  • Avoid active shoulder movements and lifting.

Phase 2 (2-6 Weeks): Controlled Motion

  • Gradually begin controlled motion exercises under the guidance of your physical therapist.
  • Focus on restoring the range of motion without straining the shoulder.

Phase 3 (6-12 Weeks): Strengthening

  • Incorporate strengthening exercises for the shoulder and surrounding muscles.
  • Continue to avoid heavy lifting or activities that place excessive strain on the shoulder.

Phase 4 (3-6 Months): Functional Training

  • Progress to functional and everyday activities as tolerated.
  • Aim to return to normal activities gradually, following your therapist’s advice.

Full Recovery After Total Shoulder Replacement Surgery:

Time Frame:

  • Full recovery can take anywhere from 4-6 months to a year, depending on the extent of the surgery and your adherence to the rehabilitation program. Most patients can return to activities like light exercise and daily tasks at 12 weeks post-op.



Baseball player extending hand out to help teammate off the ground. Baseball player has recovered from a total shoulder replacement surgery


Frequently Asked Questions (FAQs):

How long will I need to use a sling after shoulder replacement surgery?

  • Typically, you will need to use a sling for 4-6 weeks to support your shoulder.

When can I return to work after total shoulder replacement surgery?

  • This depends on your job and the extent of your surgery. Desk jobs may allow a return within a few weeks, while more physical jobs may require several months.

Will I regain full range of motion after shoulder replacement surgery?

  • With proper rehabilitation, most patients regain a significant range of motion, though individual results can vary.


Strengthen your Shoulders with Total Shoulder Replacement Surgery at AOSMI in New Jersey

Total shoulder replacement surgery is a highly effective procedure for treating severe shoulder arthritis and injury. By following the pre-surgery guidelines, preparing adequately, and adhering to the post-operative care and rehabilitation phases, you can achieve a successful recovery and regain full function of your shoulder. Always communicate with Dr. Tauro and the team of orthopedic experts at AOSMI if you have any concerns during your recovery journey. If you are experiencing shoulder pain, are considering shoulder replacement surgery, and would like a consultation, schedule an appointment with Dr. Tauro today!