Shoulder Replacement Surgery

Mr Soong Chua performs arthroplasty surgery or shoulder replacement in Melbourne, which is used to treat arthritis of the shoulder much like a hip and knee replacement.

Shoulder Anatomy

The shoulder is known as a ball-and-socket joint. The ball of the humerus (upper arm bone) fits into the glenoid cavity, which is a shallow socket located in the shoulder blade. The shoulder is constructed of three bones: The humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone).

A type of cartilage known as articular cartilage is covered on the ends of the bones. This smooth substance allows the bones to glide and move easily on each other. The remainder of the inside of the shoulder joint is covered with a thin, small tissue called synovial membrane. This membrane produces a small amount of fluid that lubricates the cartilage and eliminates friction in the shoulder.


Shoulder replacement surgery aims to treat different types of shoulder arthritis, such as degenerative, osteoarthritis, rheumatoid arthritis, or inflammatory arthritis. Using artificial components called a prosthesis, the damaged parts of the shoulder can be removed and replaced, to relieve shoulder pain and stiffness and to restore function.

The shoulder replacement surgery can involve just the ball or humerus part (hemiarthroplasty or resurfacing) of the joint or include the socket or glenoid (total shoulder replacement).

Reverse Shoulder Replacement

procedure left image

In the shoulder, there is a specific type of arthritis as a result of severe rotator cuff tears or chronic deficiency. This is known as cuff tear arthropathy and is treated with a special type of replacement called a reverse total shoulder replacement.

As a shoulder replacement surgeon, Dr Soong Chua has a particular interest in 3D computer planning, reverse total shoulder replacement, advanced bone grafting techniques, and revision shoulder replacement surgery.


Shoulder replacement surgery at Dr Soong Chua


Stemless or Partial Shoulder Replacement (Hemiarthroplasty)

In patients who develop arthritis at a younger age, hemiarthroplasty or partial shoulder replacement may be an option, to preserve as much normal anatomy for as long as possible. In this case, only the head of the humerus or the ball of the joint is replaced. The native glenoid or socket is left to articulate with the replacement head.

Newer materials including pyrocarbon have shown promising results in reducing the rate of wearing out of the native socket, preserving this for the future. This can delay or even completely avoid the need for further surgery.

A stemless or short stem shoulder replacement preserves bone stock while still providing a stable platform for the shoulder replacement. This can make it easier to perform a revision operation if the original shoulder replacement wears out as part of the natural course of events.

Conventional Total Shoulder Replacement

A conventional or anatomic shoulder replacement replaces the ball and socket of the shoulder in their normal configuration. These types of shoulder replacements rely on the rotator cuff to provide movement and function.

Provided the rotator cuff remains functional, a conventional shoulder replacement works very well at relieving pain and restoring function.

Reverse Total Shoulder Replacement

In the shoulder, a specific type of arthritis known as cuff tear arthropathy can result from severe rotator cuff tears or chronic deficiency. A conventional shoulder replacement would not be optimal for these patients as they rely on the rotator cuff for function and movement. Reverse shoulder replacement surgery would be performed in this case.

A reverse total shoulder replacement was designed in the to provide an option for patients with severe rotator cuff tears or deficiency. It reverses the orientation by placing the ball on the glenoid or socket side, and the socket on the humeral or arm side. This allows different muscles to take over, and provides movement to the shoulder which was previously not possible.

The reverse total shoulder replacement can also be used to help patients with osteoarthritis who have a pre-existing rotator cuff problem or have developed one alongside their osteoarthritis.

With over 35 years of international data, and development, the reverse shoulder replacement has been shown to have equivalent or better longevity in some cases, than conventional shoulder replacements. 10-year data from the 2018 Australian Joint Registry Report showed that the risk of revision surgery for a reverse shoulder replacement, done for osteoarthritis, is 6.8%.

Patient Specific

Developments in technology now provide surgeons with the ability to use the patient’s specific bony anatomy to plan the surgery and use ‘virtual implants’ with computer-generated models. Soong uses this technology with all of his shoulder replacement procedures and meticulously plans the surgery beforehand. Once Soong is happy with the position of the virtual implants, 3D printed, patient specific models and guides are produced and used during the surgery to ensure accuracy of implantation.

Bone Grafting

Soong has learnt and developed experience in the latest advancements in bone grafting techniques that have a particular benefit in reverse or revision total shoulder replacement. This is known as a BIORSA procedure, which aims to provide greater restoration of normal joint mechanics and increased movement and function as a result.

Revision Total Shoulder Replacement

Joint replacements are now very advanced with modern materials and manufacturing techniques such that replacements are lasting longer and longer. However, in some patients, particularly those who develop arthritis at a younger age, this may still mean that their joint replacement wears out and a revision operation may be necessary.

Revision total shoulder replacement can be indicated for various reasons including wearing out of the shoulder replacement, loss of rotator cuff function, instability or dislocations and fractures around a shoulder replacement.

This is often very complex surgery requiring specialist skills and using advanced techniques including bone grafting and specific revision prostheses (replacement parts). It can range from revising single components to removing and replacing the whole shoulder replacement.

Before Surgery

Before this surgical procedure, a CT scan will be arranged and the images loaded into a special computer program, which generates a 3D virtual model of your shoulder. Dr Chua will then place the components through a virtual simulation, to find the best match for your specific anatomy.

From this plan, a 3D printed model and guides specific to your shoulder will be generated. These will be used during the surgery for accurate insertion of the implants to match the planned position.

A comprehensive, pre-operative medical assessment with a specialist medical physician (internal medicine specialist) will be arranged for you to ensure that the procedure is carried out as safely as possible. The same doctor will also be involved in your care while you are in hospital.

You may need to have some simple investigations including blood tests and an ECG which measures the electrical activity of your heart.

In the lead up to surgery, It may be worthwhile making some simple changes in your home to make life easier when you return from the hospital. It may be hard to reach high shelving or cupboards so go through your home and place any items you need on low shelves.

Other Procedures

Not sure where to start? Give us a call us on (03) 9038 5200.