What is shoulder arthritis?
The shoulder is a ball-and-socket joint. The ball (humeral head) sits in a shallow socket on the shoulder blade (the glenoid). Cartilage covers both, letting the joint glide. In osteoarthritis, that cartilage wears thin and the bone underneath hardens and forms spurs. Shoulder arthritis also follows an old fracture or dislocation, an inflammatory condition such as rheumatoid arthritis, or loss of blood supply to the ball (avascular necrosis).
What does it feel like?
Typical symptoms are a deep ache that worsens with activity and at night, stiffness, grinding or catching, and trouble reaching up, out or behind the back. Many people lose rotation first: combing hair, putting on a coat or fastening a bra become hard. Weakness is not the main complaint, which is what separates arthritis from a rotator cuff problem.
What can I try before surgery?
Many people do well for a long time without surgery. Non-surgical care includes:
- Anti-inflammatory medicine when it is safe for you
- Heat, gentle stretching and a home exercise program, ideally guided by a therapist
- Modifying activities that aggravate the joint
- Cortisone injections for flares, usually limited to a few per year
- Sleep positioning to keep the arm supported
These help manage symptoms but do not restore cartilage.
When does shoulder replacement make sense?
Dr. Stepanyan is more likely to recommend replacement when:
- Pain interrupts sleep or limits daily tasks despite non-surgical care
- Motion is significantly limited
- X-rays or CT show advanced arthritis
- The rotator cuff is intact and healthy enough to support an anatomic implant
- You understand the limits on lifting and activity afterward
If the rotator cuff is torn beyond repair, a reverse shoulder replacement is generally the better choice.
What happens in surgery?
Surgery typically takes one to two hours under general anesthesia with a nerve block. Dr. Stepanyan removes the arthritic head of the humerus and replaces it with a metal ball on a stem, and resurfaces the socket with a smooth plastic component. CT scans can help plan how the socket is worn, because the shape of that wear affects component choice and positioning. A tendon called the subscapularis must be detached and carefully reattached to allow access, and protecting that repair is the central feature of early recovery. Most patients stay one night.
What outcomes can I expect?
Most patients get dependable pain relief and better motion, and many resume activities such as swimming, golf and gardening. Heavy lifting and impact sports are discouraged to protect the implant.
Should I get a second opinion?
If you have been told you are too young for a shoulder replacement, or that you need one and are not sure, a second opinion is worthwhile. Request a visit and bring your X-rays and any CT or MRI.
Where can I see Dr. Stepanyan?
Dr. Stepanyan sees shoulder patients in Glendale, East LA and Santa Fe Springs. He operates at Adventist Health Glendale, Glendale Memorial Hospital, Adventist Health White Memorial and White Memorial Montebello, Providence Saint Joseph Medical Center and Avalon Surgery Center.
What does recovery look like?
These are typical stages after an anatomic shoulder replacement. Your own plan may differ.
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Weeks 0–6
Protect the repair
You wear a sling and avoid active use of the arm, because the subscapularis tendon is healing. Gentle passive motion and elbow, wrist and hand exercises begin early.
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Weeks 6–12
Restore motion
The sling comes off. Active motion and light daily tasks resume, and therapy works on rotation.
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Months 3–6
Build strength
Strengthening starts. Most people return to driving, light recreation and gentle swimming.
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Months 6–12
Full recovery
Strength and comfort continue to improve for up to a year. Dr. Stepanyan will give you guidelines for lifting and sport.
Follow the restrictions you are given. Early overreach is the most common way to strain the tendon repair.