Two designs, one decision that matters
An anatomic total shoulder resurfaces the ball and socket in their normal configuration — the right choice when the rotator cuff is intact. A reverse total shoulder swaps the ball and socket positions so the deltoid powers the arm — the design of choice when the rotator cuff is deficient, for cuff-tear arthropathy, and for many complex fractures. Choosing correctly is the surgeon’s job, and it starts with your cuff.
CT-based planning
Every shoulder replacement Dr. Pettit performs is planned from a pre-operative CT scan, which maps your bone anatomy and wear pattern in 3D so implant position and version are decided before surgery. The CT scan is a required part of your pre-surgical workup.
What surgery and early recovery look like
Surgery typically takes about two hours. Anatomic replacements protect the subscapularis repair early — a sling for four to six weeks with staged motion and no active internal rotation early on. Reverse replacements wear a sling for six weeks with dislocation precautions (no combined reaching behind the back) for twelve weeks, progressing from passive to active motion as the shoulder heals.
Results & expectations
Pain relief is the most reliable outcome — most patients sleep through the night again within weeks. Motion goals differ by design: anatomic shoulders commonly reach 140–150° of elevation; reverse shoulders typically achieve functional overhead motion of 80–120°+ with long-term lifting guidelines to protect the implant.
Frequently asked questions
How do I know if I need anatomic or reverse?
Your rotator cuff decides. Intact cuff plus arthritis favors anatomic; a deficient cuff, cuff-tear arthropathy, or certain fractures favor reverse. The exam, MRI/CT, and Dr. Pettit’s assessment determine the recommendation.
How long is the sling worn?
Anatomic: four to six weeks. Reverse: six weeks, with no driving during that period. Both come off for prescribed home exercises.
What are the long-term restrictions?
Reverse shoulders carry commonsense lifetime guidelines — commonly around 15 lb below shoulder height and 10 lb overhead, avoiding repetitive heavy loading like push-ups and bench press. Anatomic shoulders have fewer limits once healed.
When can I golf again?
Many patients return to golf around four months after anatomic replacement, and to modified recreation after reverse replacement per the protocol milestones.
See Dr. Pettit
5 locations across Cincinnati & Northern Kentucky · (513) 354-3700