2. Indications – A total shoulder arthroplasty is offered to individuals with arthritis of the shoulder, a functioning rotator cuff and good bone stock. This procedure is used for primary and secondary osteoarthritis, posttraumatic arthritis, capsulorrhaphy arthropathy, and inflammatory arthritis.

3. Technique – 

Important considerations of the glenoid 
The glenoid component Part 1
The glenoid component Part 2
Technique for insertion of the glenoid component
Technique for minimizing risk of loosening

The subscapularis

Antibiotics after joint replacement

Once the range of motion is well established and after 6 weeks, we usually start early strengthening and

5. Results – The results of total shoulder arthroplasty depend on the diagnosis for which the procedure is performed: best results are obtained for primary osteoarthritis, while less optimal results may be see with post traumatic arthritis or chondrolysis. The results also depend on the physical and mental health of the patient: active patients without major medical or emotional issues fare better. The results also depend on the type of procedure: the best reported results have been obtained with all-polyethlene components, for example. Finally, the results depend on the experience of the surgeon: surgeons performing many of these procedures each year have better results and fewer than those who perform them rarely. Overall, the results of total shoulder arthroplasty can be summarized as posted here. Additional posts are listed below.

6. Complications – the possible risks of the total shoulder procedure include stiffness, pain, infection, fracture and glenoid component failure. If stiffness and pain are persistent at six weeks after surgery, a gentle manipulation under anesthesia with complete muscle relaxation is often helpful. If stiffness is present months after the procedure, a surgical soft tissue releaseis an option. Infection is uncommon after this procedure, especially if advanced prophylactic antibiotics (Ceftriaxone and Vancomycin) are used before and for a day after surgery. Fractures are extremely rare with the impaction bone grafting technique. Glenoid component failure is a concern and make take the form of either wear or loosening. The glenoid component is at risk because, in contrast to the situation in hip arthroplasty, the glenoid component is often loaded away from its center = eccentric loading. This eccentric loading can cause local wear and cold flow of the polyethylene. It can also give risk torocking horse loosening of the glenoid component. This complication can be minimized by careful attention to surgical technique, including the use of a pegged all-polyethlene glenoid component, careful reaming of the glenoid bone so that a close fit is obtained with the back of the component, minimizing the use of cement, assurance that the humeral component is centered in the glenoid, accurate soft tissue balancing, and careful rehabilitation that protects the subscapularis and the rotator cuff.

Other posts related to the subscapularis can be found below:

Eccentric and offset heads
Humeral head selection
Attempt to restore normal anatomy
Stemless
Other posts related to the glenoid can be found below:
Reaming hazards
Pegged vs keeled?
«Magic peg» glenoid
Glenoid component fixation
Positioning
Glenoid version and stability
Evaluating and managing glenoid bone loss
Effect of glenoid deformity on glenoid component positioning
Bone graft for glenoid erosion
Vacuum assisted fixation
Wedge-shaped glenoid component
Pegged glenoid 

Glenoid component failure
Glenoid loosening
Glenoid failure
Patterns of glenoid component loosening
Glenoid lucent lines and loosening Osteolysis with components radiated in air
Associated with retroversion

Rocking horse loosening 
Early migration of the component
Associated with delayed cuff dysfunction 1
Associated with delayed cuff dysfunction 2

Total Shoulder Replacement