- Type
- Complex re-do shoulder arthroplasty
- Anaesthesia
- General + regional block
- Hospital stay
- 1 night
- Sling
- 1 week (most commonly converted to reverse)
- Driving
- ~2 weeks
- Recovery to final outcome
- 9–12 months
What it is.
A revision shoulder replacement is a re-do shoulder arthroplasty — performed because an earlier shoulder replacement has developed a problem. Revision shoulder surgery is technically demanding, requires careful planning, and is among the most complex operations in orthopaedic surgery. Dr Coory's Bateman fellowship subspecialty training was specifically focused on this kind of work.
Indications.
- Component loosening — the implant has worked loose from the bone. The glenoid component is the most common site.
- Component wear — the polyethylene liner has worn out, or the metal has worn into the bone.
- Infection — deep infection of the prosthesis. May require staged surgery (remove the prosthesis, treat with antibiotics, re-implant later).
- Instability or dislocation — the prosthesis dislocates repeatedly.
- Periprosthetic fracture — a new fracture around the existing implant.
- Cuff failure after anatomic TSA — conversion to a reverse arthroplasty.
The work-up.
Revision arthroplasty starts with a careful diagnostic process. Infection must be actively excluded before any revision is planned. The standard work-up includes plain radiographs, blood markers (CRP, ESR), a joint aspirate where indicated, and a CT scan to plan available bone stock. The diagnosis — loosening, wear, instability, infection or fracture — defines the operative plan.
The operation.
Performed under general anaesthesia with a regional block, the operation re-uses the original incision wherever possible. The existing components are carefully removed; the goal is to preserve bone stock. Tissue samples for culture are taken if there is any suspicion of infection. Bone defects are reconstructed with bone graft or augmented implants. The new components — commonly a reverse arthroplasty — are implanted to a CT-based plan, with careful attention to soft-tissue balance.
Outcomes.
Outcomes after revision arthroplasty are less predictable than primary arthroplasty. Pain relief is the most consistent benefit; functional gain is more variable and depends on the integrity of the deltoid, the available bone stock, and the underlying indication. Dr Coory will discuss the realistic functional goals for your specific case at consultation.
Recovery guidance
Your physiotherapist receives specific post-operative instructions on the day of surgery. View the recovery roadmap for the full rehabilitation journey, or visit For Physiotherapists for protocol requests.
Frequently asked questions.
Is revision surgery higher-risk than the first operation?
Yes. Revision arthroplasty has a higher rate of infection, periprosthetic fracture, instability and other complications than primary arthroplasty. The risk is discussed in detail at consultation and reflected in the informed-consent process.
How do you tell if my old replacement is infected?
Infection work-up includes blood markers (CRP, ESR), plain radiographs, and where indicated a joint aspirate sent for microbiology. Active infection is excluded before any one-stage revision is planned. Suspicious cases are managed with staged surgery.
Will my function improve?
Pain relief is the most consistent benefit. Functional gain depends on the underlying indication and the soft-tissue state. Dr Coory will give a realistic expectation at consultation.
How long do I stay in hospital?
One night is typical, with most revision cases converted to a reverse arthroplasty using the same accelerated post-operative protocol (sling for one week, active-assisted physiotherapy from week 1).
Will the new implant last as long as the original?
Implant survival after revision is shorter on average than after primary arthroplasty. The exact estimate depends on the indication, bone stock and the components used.
References.
- Australian Orthopaedic Association National Joint Replacement Registry. Shoulder Arthroplasty Annual Report. Adelaide: AOA; 2024.
- Boileau P. Complications and revision of reverse total shoulder arthroplasty. Orthop Traumatol Surg Res. 2016;102(1):S33–S43.