Reverse vs Anatomic Shoulder Replacement Explained

The key difference: an anatomic (conventional) replacement mimics the normal shoulder — ball on the arm bone, socket on the shoulder blade — and needs a healthy rotator cuff, while a reverse replacement swaps them, placing the ball on the shoulder blade and the socket on the arm bone, so it relies on the deltoid and works when the tendons are damaged.

✅ Last medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery, on 5 October 2026

About your surgeon: Prof. Dr. Ibrahim Shaarawi

Professor of Orthopaedic Surgery, Faculty of Medicine, Ain Shams University.
Visiting Professor of Orthopaedic Surgery, Ohio, USA.
Certificate in complex fractures and trauma, University of Maryland, USA.
He has performed 55 reverse shoulder replacements, and his joint replacement experience includes 650 total hips, 1,400 hip hemiarthroplasties and more than 750 knee replacements.
In shoulder surgery he has performed more than 550 arthroscopic Bankart repairs and more than 115 Latarjet procedures.
Rated 4.9 and 5.0 on Google by about 300 patients.

He sees patients at his clinics in Nasr City, Mohandeseen and New Cairo (5th Settlement).

What a shoulder implant looks like

Anatomic shoulder replacement: metal head on the arm bone and socket on the shoulder blade — Anatomic implant components; in a reverse implant the ball and socket swap places.

Stem: a metal part fixed inside the arm bone (short or stemless in some designs).
Head or cup: a round metal head in the anatomic implant, or a polyethylene-lined cup in the reverse.
Shoulder-blade component: a polyethylene socket in the anatomic, or a metal ball (glenosphere) fixed with screws in the reverse.

Key numbers to know

Reverse shoulder replacement survival was 93% at 10 years, with complications in 29% and revision in 12% in a follow-up of 191 implants (Bacle et al., JBJS 2017).
Shoulder replacements increased 5.6-fold between 1998 and 2017, and the risk of a serious adverse event within 30 days was 3.5% (1 in 28) (Craig et al., BMJ 2019).
The lifetime risk of revision ranges from 1 in 37 in women over 85 to 1 in 4 in men aged 55–59 (Craig et al., BMJ 2019).

At Prof. Dr. Ibrahim Shaarawi’s clinics in Nasr City, Mohandeseen and New Cairo (5th Settlement) we examine the shoulder and review your X-rays and MRI at the same visit, assessing the tendons and bone before choosing conservative care or the right implant.

The types compared

	Reverse	Anatomic (total)	Hemiarthroplasty
Design	Ball on shoulder blade, cup on arm bone	Ball on arm bone, socket on shoulder blade	Metal head on the arm bone only
What lifts the arm	Deltoid	Rotator cuff with deltoid	Rotator cuff with deltoid
Suits	Damaged tendons, complex fractures in older adults, failed surgery	Arthritis with healthy tendons and good bone	Selected cases
Expected result	Major pain relief and better elevation; rotation may stay limited	Major pain relief with near-normal motion	Variable
Early restrictions	No pushing up with the arm or reaching behind the back	Protecting the subscapularis repair	Per surgeon

Table 1: Types of shoulder replacement compared.

How does the surgeon choose?

The state of the rotator cuff — the most important factor.
The amount and quality of shoulder-blade bone on CT.
The cause: arthritis, fracture or failed surgery.
Age, activity and expectations.

Comparative studies show both relieve pain well when each is used for the right patient, while the anatomic design usually gives better rotation. There is no single “best” — only what suits your tendons and bone.

Video: success rate of arthroscopic rotator cuff repair

When the tendons can be repaired, arthroscopic repair is preferred over replacement; Prof. Dr. Ibrahim Shaarawi discusses its success rate (in Arabic).

Frequently asked questions about shoulder replacement types

What is the difference between reverse and anatomic shoulder replacement?

The anatomic design mimics the normal shape and needs healthy tendons; the reverse swaps ball and socket and relies on the deltoid, so it suits damaged tendons.

Which is better, reverse or anatomic?

Neither is better overall; the right choice depends on your rotator cuff, shoulder-blade bone and the cause of the problem.

What is a shoulder implant made of?

A stem or component in the arm bone, a head or cup, and a shoulder-blade component, made of metal alloys and highly durable polyethylene.

Does a reverse replacement limit movement?

It usually improves lifting clearly, but internal rotation — such as reaching behind the back — may stay limited.

Can an anatomic replacement be converted to a reverse?

Yes. If an anatomic replacement fails because the tendons later tear, it can be converted to a reverse in revision surgery.

To have your shoulder assessed, book a consultation, call +20 155 240 4488 or message us on WhatsApp at +20 155 554 7181.

Medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery. This article is general medical education and does not replace an examination or the plan your surgeon sets for you. See our medical disclaimer.

Related shoulder replacement guides

For the operation itself see reverse shoulder replacement, and read:

Reverse vs Anatomic Shoulder Replacement: Types of Shoulder Implants Explained