Total or reverse
Roundtable · 8 threads
Working out which operation your shoulder needs, and why the rotator cuff, not your age, tends to decide it.
The question that brings most people to this section is not whether to have surgery but which surgery to have. Two surgeons can look at the same painful shoulder and, depending on what the rotator cuff is doing, land on a total (anatomic) replacement, a reverse one, or a partial. The threads here are readers untangling that choice, comparing what they were told, and reporting back on how the operation they ended up with actually performs.
Read these before your consultation
A pattern runs through this section: the readers who felt settled about their operation were the ones who understood that the state of the rotator cuff, not their birthday, drove the decision. A working cuff generally points to an anatomic total replacement; an irreparable cuff with arthritis points to a reverse, where the deltoid does the lifting instead. The site's guide to an anatomic versus a reverse shoulder replacement lays out that fork, and choosing a shoulder surgeon turns it into questions you can actually put to the person operating.
The other recurring theme is expectation. A reverse replacement is superb at giving back the power to lift the arm, but it is not identical to a natural shoulder, and internal rotation (reaching behind your back) can stay limited. Readers who knew that going in were pleased; those expecting a brand-new twenty-year-old joint were not.
What this section cannot do is tell you which operation your shoulder needs. Only a surgeon holding your imaging and examining the cuff can weigh that. Come with the question, not the conclusion.