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Shoulder Arthritis Non-Surgical Treatment

When nonoperative treatment no longer provides adequate relief and shoulder arthritis is significantly limiting daily life, surgery can restore comfortable, functional motion. The most effective and durable treatment is shoulder replacement, in which the damaged joint surfaces are replaced with implants. Dr. Rynecki Baker performs both types of shoulder replacement and selects the most appropriate option based on each patient’s anatomy, the condition of the rotator cuff, and their goals.

Surgery is typically recommended for patients who have:

  • Pain that persists despite nonoperative care: Symptoms that continue after therapy, medication, and injections
  • Night pain: Shoulder pain that regularly interrupts sleep
  • Loss of function: Difficulty with work, sport, dressing, or self-care because of pain or stiffness
  • Advanced arthritis on imaging: Bone-on-bone changes, particularly with progressive wear or bone loss in the socket
  • Rotator cuff tear arthropathy: Arthritis with a massive, irreparable cuff tear and loss of the ability to lift the arm

Prior to surgery, Dr. Rynecki Baker uses CT scanning to create a detailed, three-dimensional picture of each patient’s shoulder anatomy. Shoulder arthritis rarely wears the socket evenly, and the degree and direction of that wear determine how the implant must be positioned to sit securely on healthy bone. Planning implant selection and placement in advance, before entering the operating room, allows the procedure to be executed precisely and is one of the most important factors in the long-term durability of a shoulder replacement.

Total Shoulder Replacement

In anatomic total shoulder replacement, both the ball and the socket are resurfaced with prosthetic implants that recreate the shoulder’s normal geometry. This procedure is most appropriate for patients with an intact, functioning rotator cuff, and it is highly effective at relieving pain and restoring motion. Implant design has evolved considerably, and in patients with good bone quality the humeral component can often be shorter or stemless, which preserves bone and simplifies any future revision. Dr. Rynecki Baker selects implants and technique based on each patient’s individual anatomy to optimize longevity and function.

Reverse Total Shoulder Replacement

In patients with rotator cuff tear arthropathy, or those with significant rotator cuff deficiency alongside shoulder arthritis, a reverse total shoulder replacement is the preferred solution. This implant reverses the normal ball-and-socket geometry of the joint, allowing the deltoid muscle to compensate for the absent rotator cuff and restore reliable overhead function. Reverse replacement is also used when the socket has worn severely or when bone loss makes a standard socket implant unlikely to remain securely fixed. Dr. Rynecki Baker uses this procedure to restore meaningful function even in the most complex patterns of shoulder arthritis.

Hemiarthroplasty

In a hemiarthroplasty, only the ball is replaced, and the socket is left alone. Its role today is narrower than it once was. For typical osteoarthritis with a worn socket, a total shoulder replacement relieves pain more reliably, because a resurfaced ball articulating against arthritic cartilage often remains uncomfortable, and over time the implant can wear the socket further. It remains the right choice in specific situations: avascular necrosis in which the humeral head has collapsed but the socket cartilage is preserved, certain fractures and post-traumatic cases, and younger patients in whom the expected lifespan of a socket component is a genuine concern or in whom the socket bone will not support one securely. In those patients it preserves bone and leaves the reconstructive options open for the future.

Revision and Conversion to Reverse Replacement

Some patients come to Dr. Rynecki Baker with a shoulder replacement that is no longer working, whether because the rotator cuff has failed around an anatomic implant, the socket component has loosened, or bone loss has developed over time. Converting an anatomic replacement to a reverse replacement addresses these problems and can restore function to a shoulder that had become painful and unreliable. These are complex operations that depend heavily on preoperative planning and on managing bone loss, and Dr. Rynecki Baker plans them with dedicated imaging and a clear discussion of what the revision can and cannot restore.

Arthroscopic Treatment for Younger Patients

For younger patients with early arthritis who are not yet candidates for replacement, arthroscopic surgery can relieve symptoms and delay a replacement. Through small incisions, loose fragments and inflamed tissue are removed, bone spurs at the bottom of the humeral head are addressed, and the tight capsule is released to restore motion. This does not cure arthritis, and Dr. Rynecki Baker is direct about that, but in appropriately selected patients it can provide years of improved comfort and function.

After shoulder replacement

Recovery requires commitment to a structured rehabilitation program:

  • Sling protection: Most patients wear a sling for several weeks while the soft tissues heal.
  • Early motion: Gentle, protected motion begins early, with the specific restrictions depending on which type of replacement was performed. After an anatomic replacement, the repaired tissue at the front of the shoulder is protected from outward rotation during the early weeks.
  • Strengthening: Progressive strengthening follows once motion has been restored, typically beginning around six weeks.
  • Return to activity: Most patients return to daily activities within a few months, with continued improvement over the first year. Dr. Rynecki Baker provides specific long-term activity guidelines to protect the implant.

After arthroscopic treatment

Recovery is faster. Motion is started immediately, the sling is used only briefly or for comfort, and strengthening begins once symptoms allow.

Every patient receives a written protocol specific to the procedure performed, and Dr. Rynecki Baker works closely with each patient and their physical therapist throughout recovery.

If you have shoulder arthritis and are considering surgery, contact Dr. Nicole Rynecki Baker’s office today to schedule a consultation.

At a Glance

Dr. Nicole Rynecki Baker

  • Fellowship-Trained Sports Medicine at HSS
  • Assistant Professor of Orthopedic Surgery at NYU
  • New York Knicks Medical Staff (2025-2026)
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