Total shoulder replacement, also called shoulder arthroplasty, is a surgical procedure that removes damaged areas of the shoulder joint and replaces them with artificial components made of metal and plastic. The shoulder is a ball-and-socket joint formed by the head of the humerus (upper arm bone) and the glenoid socket of the shoulder blade. Damage to this joint can lead to persistent pain, stiffness, weakness, and loss of motion that interferes with daily activities. Total shoulder replacement is a surgical option considered when shoulder pain, stiffness, and loss of function significantly interfere with daily life and have not improved with nonsurgical treatments such as medication, injections, or physical therapy. Conditions that may lead to shoulder replacement include osteoarthritis, rheumatoid arthritis and other inflammatory disorders, severe rotator cuff injuries, complex fractures of the upper humerus, osteonecrosis caused by disrupted blood supply to the bone, and failed prior shoulder surgeries. The process begins with a comprehensive evaluation by an orthopedic specialist, who reviews symptoms, medical history, and functional limitations, followed by a physical examination and imaging studies such as X-rays or CT scans to assess the condition of the joint. Based on the pattern of damage and the health of the surrounding muscles and tendons—particularly the rotator cuff—the surgeon determines whether a total, partial, or reverse shoulder replacement is most appropriate. Once surgery is recommended, patients undergo preoperative preparation to ensure they are medically ready and understand what recovery will involve. This typically includes reviewing medications, addressing factors that could affect healing, and discussing anesthesia and pain management. Many patients also meet with a physical therapist before surgery to learn about early exercises and how to safely use a sling or immobilizer after the procedure. Planning ahead for help at home is encouraged, as the arm will have limited use during the early recovery period. On the day of surgery, anesthesia is administered—most often general anesthesia combined with a nerve block to help control pain afterward. During the procedure, the surgeon removes damaged bone and cartilage from the shoulder joint and replaces them with artificial components designed to restore smoother movement. The surgery itself usually takes one to two hours. Afterward, patients recover in a monitored setting while the anesthesia wears off, and imaging may be performed to confirm proper implant positioning. Many patients are able to return home the same day, while others may stay overnight depending on individual needs. Recovery continues at home with the arm supported in a sling to protect the joint as healing begins. Physical therapy starts early and progresses gradually, focusing first on gentle movement and later on rebuilding strength and function. Rehabilitation plays a critical role in overall outcomes, and patients are guided on activity restrictions, wound care, and how to safely resume daily tasks. While pain typically improves significantly after surgery, full recovery takes time, often several months, with continued gains in strength and mobility over the first year. For most people, total shoulder replacement results in meaningful pain relief and improved ability to perform everyday activities. As with any surgery, there are risks, and long-term success depends on proper healing, rehabilitation, and following medical guidance. The overall goal of the process is not only to replace a damaged joint, but to restore comfort, movement, and quality of life in a way that supports long-term shoulder health.