Total or reverse
Roundtable · 4 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.
| Thread | Replies | Views | Last post |
|---|---|---|---|
| Reverse replacement and I can lift overhead fine now but still can't reach behind my back. Is that limit permanent? started by deltoid_derek, Jul 1, 2026 | 4 | 280 | deltoid_derek Jul 8, 2026 |
| My good shoulder was a total and it's brilliant, now the other one needs a reverse and it feels like the consolation prize. Is a reverse a downgrade? started by keencaravanner, Apr 10, 2026 | 5 | 300 | keencaravanner May 2, 2026 |
| Told it's a total OR a reverse depending on my rotator cuff, not my age. Can someone explain why the cuff decides? started by deltoid_derek, Jan 14, 2026 | 4 | 320 | deltoid_derek Feb 3, 2026 |
| Offered a partial (hemiarthroplasty) after I broke the top of my arm. Is a partial worse than a full replacement? started by onearm_gardener, Oct 9, 2025 | 5 | 280 | onearm_gardener Nov 4, 2025 |
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.