Shoulder Revision Surgery

You might need a revision if your joint is infected, painful or not working correctly. The procedure involves removing the original prosthetic and replacing it with a new artificial joint. Depending on your condition, a reverse total shoulder replacement may be recommended. 

How revision shoulder replacement differs from initial surgery

In a standard shoulder replacement, your surgeon replaces the damaged joint with an artificial one. In revision surgery, that artificial joint is removed and replaced again. Though most shoulder replacements last for many years, revisions may be needed if problems develop. 

Shoulder replacements have two main components - the ball and socket of the joint. A reverse total shoulder replacement may be required in some cases, especially if the rotator cuff is damaged. In a revision, one or both components may need to be replaced. 

Because the procedure is more complex, revision surgery carries a higher risk of complications and may require more than one surgery.

Why revision shoulder replacement surgery may be needed

A shoulder revision may be required if the original replacement fails due to: 

• Instability or dislocation 
• Stiffness or limited range of motion 
• Persistent shoulder pain 
• Weakness in the arm or shoulder 
• Overuse or physical stress on the joint 
• Infection 
• Loosening or wear of the implant 
• Malpositioned components 
• Bone spurs or scar tissue 
• Nerve injury 
• Reaction to implant materials 
• Fracture 
• Rotator cuff failure 
• Poor post-surgery rehabilitation 

Identifying the cause of failure is important to guide your revision treatment plan. 

To prepare for surgery: 

• Review your health history and past surgery records with your surgeon. 
• Stay active to improve strength and recovery—ask your doctor what’s safe. 
• Stop smoking to lower the risk of complications. 
• Manage chronic conditions like diabetes or heart disease. 
• Plan for help at home after surgery. 
• Set up your home to make recovery easier (move frequently used items within easy reach, prepare meals in advance). 
• Follow instructions on medications, fasting and bathing before surgery. 

Tests and imaging before revision shoulder surgery

To understand the problem with your original joint, your provider may order: 

• X-rays, MRIs or CT scans 
• Aspiration or biopsy (if infection is suspected) 
• Nerve conduction tests or ultrasound 

These help determine what needs to be replaced, though some decisions may be made during surgery. 

Before surgery, it’s important to understand the risks, recovery time and expected results: 

• Longer recovery: Recovery takes longer than primary shoulder replacement and may require several months. 
• Higher risk: Revision procedures are riskier due to scar tissue, altered anatomy and complications from prior surgeries. 
• Potential limitations: Results may not be as favorable as with first-time shoulder replacements. 
• Commitment to rehab: Physical therapy is essential to restore movement and strength. 

Not everyone is a candidate. People in poor health or those unable to complete rehabilitation may not qualify for revision surgery.

What to expect during revision shoulder surgery

Revision shoulder surgery is usually performed under general anesthesia and takes several hours. Here's what typically happens: 

• The surgeon reuses prior incision sites when possible. 
• The artificial joint is removed—this may include the ball, socket or both. 
• Cement, scar tissue, or infected tissue may be removed. 
• A bone graft may be used if bone needs to be rebuilt. 
• Soft tissues like tendons or ligaments may be repaired. 
• A new artificial joint is placed—often a reverse shoulder replacement is used. 

If you're having surgery due to a fracture, screws, plates or wires may be used. In cases of infection, antibiotics may be given for several weeks. Some infections may require multiple surgeries. 

Immediate recovery after shoulder revision surgery

After the procedure: 

• You'll move to recovery to be monitored as anesthesia wears off. 
• Pain medication will be provided. 
• Physical therapy often begins during your hospital stay. 
• Most patients go home within 1–2 days.

At-home recovery after revision shoulder replacement

Full recovery takes longer than a first-time shoulder replacement. Important tips: 

• Follow all instructions for wound care and follow-up visits. 
• Don’t lift anything for 2–4 weeks; avoid heavy lifting for two months. 
• Avoid pushing up from a bed or chair with your affected arm. 
• Wear a sling for 2–6 weeks. 
• Avoid certain arm positions (like extending behind your back). 
• You can typically return to a desk job after 2 weeks. 
• Full recovery—including return to sports—can take 6–12 months. 

As with any surgery, risks exist. These include:

• Infection
• Loosening or dislocation of the implant
• Stiffness
• Nerve injury
• Rotator cuff tears

Your care team will help you minimize these risks through close monitoring and physical therapy.

Long-term outlook after revision surgery

Most patients do well after revision surgery. You may not regain your full range of motion, but many people experience: 

• Less pain 
• Improved movement and function 
• Better quality of life 

Trust your care to the experts at Banner Health. Our orthopedic team specializes in complex revision procedures and uses advanced imaging, surgical techniques and rehabilitation programs to help you recover and get back to what you love. 

Whether you’re experiencing joint pain, implant issues or need a second opinion, we’re here to help.