Questions to Ask Before a Shoulder Replacement

The best questions to ask before a shoulder replacement cover four things: which of the three operations your shoulder needs and why, the surgeon’s own results and experience, how common the main risks are, and what a realistic recovery and outcome look like for you. Going in with a written list turns a rushed appointment into a genuine conversation, and it is the simplest way to reach a confident, informed decision¹.

I went to my first consultation with a head full of worries and came out having asked almost none of them, then spent the drive home remembering all the things I had meant to say. So I went back with a list. This article is that list, refined and checked by a consultant shoulder surgeon, and written to be neutral: these are questions to ask whichever surgeon you see. For the whole picture of the operation first, start with our guide to shoulder replacement.

Why bring a written list?

A written list is worth more than you would expect, because it is genuinely easy to forget your questions once you are in the room. Consultations are short, the information arrives quickly, and worry crowds out memory. Taking someone with you to note the answers helps too, and no reasonable surgeon minds a patient who has come prepared².

The one thing I would say from the other side of it: write down the questions that are actually keeping you awake, not the ones you think you are supposed to ask. Mine were about the sling and about how long the thing would last, and those were the answers that let me plan the rest.

Questions about which operation you need

Ask which of the three operations you need and why, because the state of your rotator cuff, not your age, mainly decides between an anatomic total replacement, a reverse replacement, and a hemiarthroplasty. An intact cuff usually points to a total; a torn, irreparable cuff with arthritis points to a reverse, where the deltoid muscle lifts the arm in place of the cuff³.

Useful questions to have on the list:

• Do I need a total, a reverse, or a partial replacement, and what in my shoulder makes it that one?
• Can you show me the finding on my own scan that drives the choice?
• What does my rotator cuff look like, and does that change the plan?
• What movement can I realistically expect from that operation?

The point that floored me was that my ruined cuff, not my birthday, was why I was having a reverse rather than a standard total. If that fork is live for you, our comparison of an anatomic versus a reverse shoulder replacement sets out who each one suits.

Questions about the surgeon and their results

It is reasonable, not rude, to ask how many shoulder replacements the surgeon does each year, their own infection and revision rates, and whether their outcomes are submitted to a registry. Shoulder replacement rewards a surgeon who does it in volume, and outcomes across the country are tracked by the National Joint Registry, so these are ordinary questions to a specialist⁴.

Worth asking:

• How many shoulder replacements do you perform a year, and how many of the type I need?
• What are your own infection and revision rates?
• Do your results go to the National Joint Registry?
• Who does my follow-up and my physiotherapy, and for how long?

When I finally put these to my surgeon he answered without hesitation, which in itself settled me. Surgeons who keep track of their numbers are used to the question. There is more on what to look for in choosing a shoulder surgeon.

Questions about the risks

Ask for the specific figures rather than vague reassurance: infection affects roughly 1 in 100 (about 1%, reported from 0 to 4%) of primary shoulder replacements, somewhat higher after a reverse, and other named risks are nerve injury, dislocation, loosening, and a fracture around the implant. Nerve injury is most often a temporary stretch of the axillary nerve, and dislocation is more common after a reverse replacement than an anatomic one⁵.

Questions to put directly:

• How common is infection for an operation like mine, and what do you do to prevent it?
• What is the risk of a nerve injury, and is it usually temporary?
• How likely is dislocation, particularly with a reverse?
• What would eventually bring this shoulder back to surgery?

No joint replacement is risk-free, and the shoulder is major surgery under anaesthetic. Our full account, with each complication and how likely it is, is in shoulder replacement risks and complications.

Questions about recovery and the sling

Ask the recovery questions that let you arrange help and time off, because most of the first weeks are spent living one-handed: the arm rests in a sling for about 2 to 6 weeks (commonly 3 to 4, often sooner for a reverse), driving returns at around 6 weeks, and desk work between roughly 2 and 6 weeks. Heavier or overhead work waits 3 to 6 months, and the shoulder keeps gaining strength and movement over 6 to 12 months¹.

Have these ready:

• How long will I be in the sling, and how much can I do one-handed?
• When can I drive, return to work, and lift again?
• When does physiotherapy start, and how much of the result depends on me doing it?
• How long until this feels like the finished result?

The honest answer that no clinic page had given me was that the arm I actually wanted turned up nearer the six-month mark than the six-week one, and the rehab did as much for it as the surgery. Ask the surgeon to walk you through that timeline for your own case, week by week, so you can arrange the help and the time off you will need.

Questions about the honest outcome

Finally, ask what a good result actually looks like for a shoulder like yours: around 90% of patients report a good or excellent outcome and roughly 90% to 95% have less pain and better function, but the operation relieves pain and gives back a working arm rather than a twenty-year-old shoulder. Overhead and rotational range improves rather than returns in full, and the joint should not be loaded like an undamaged one².

The questions I would not skip:

• What movement and strength are realistic for me, and what will still be off limits?
• How long is this likely to last, and what if it needs redoing? (most last well, with around 90% still in place at 10 years, and a roughly 1% per year revision risk after that)
• What if I wait, and what non-surgical options are left?

Asking the surgeon to be candid about my likely result, rather than the best-case one, was the single most useful thing I did. Our honest weigh-up from the other side, including the limits the operation will not clear, is in is a shoulder replacement worth it.