Shoulder Replacement Surgery
in Rockhampton

What is going on

Shoulder replacement is the surgical treatment for advanced shoulder arthritis or for irreparable rotator cuff tears with cuff-tear arthropathy. Patients describe a deep, persistent ache in the shoulder, loss of overhead reach, difficulty sleeping on the affected side, and grinding when the arm is moved. X-rays show loss of joint space, bony spurs, and in cuff arthropathy, an upward migration of the humeral head as the cuff fails. The decision between an anatomic total shoulder replacement and a reverse shoulder replacement depends on the state of the rotator cuff: anatomic if the cuff is intact and the bone glenoid is workable, reverse if the cuff is failed.

Not sure if this is the right diagnosis? The shoulder pain hub and shoulder injury hub triage the differential by anatomical location.

What the operation involves

An anatomic total shoulder replacement substitutes the diseased humeral head and glenoid with metal and polyethylene components shaped to mimic the natural anatomy. A reverse arthroplasty inverts the geometry — a ball on the glenoid and a socket on the humerus — so the deltoid can power the arm in the absence of a working cuff. Either operation takes around 90 to 120 minutes under regional and general anaesthesia, with a one to two night hospital stay. Full clinical detail and the choice between procedures is on the education page, and the shoulder arthritis education page covers the underlying condition.

For full clinical detail — incision, anaesthetic, post-operative instructions and the printable patient handout — see the shoulder replacement education page or the shoulder surgery overview.

How this case is handled

Shoulder replacement is a major operation where the practice strongly favours coordinated peri-operative care — pre-admission planning, in-hospital pain control, structured early physiotherapy, and a defined six-week / three-month / six-month follow-up cadence. In-person review is preferred at each checkpoint; telehealth review can be arranged for patients from outside Rockhampton where travel is genuinely a barrier.

Fees, Medicare rebates and the surgery-quote process are on the fees page. The case for seeing a fellowship-trained surgeon — and what fellowship training adds — is set out separately. GPs can find the referral pathway, urgency triage and what to include in the letter on the referrer page.

What this operation is billed under

The procedure is covered by the following Medicare Benefits Schedule items. Surgeon, anaesthetist, assistant, hospital and prosthesis fees are quoted separately and in writing before surgery — see the fees page for the practice's quote process and an explanation of why surgical fees follow the Australian Medical Association schedule. Surgery does not proceed without itemised written informed financial consent.

Item 48918 Total or reverse shoulder arthroplasty

Without bone graft

Item 48919 Total or reverse shoulder arthroplasty

With bone graft

Item 48921 Revision shoulder arthroplasty

Without bone graft

Item 48924 Revision shoulder arthroplasty

With bone graft

Patient questions we hear most

• What's the difference between an anatomic and a reverse shoulder replacement?

  An anatomic shoulder replacement keeps the natural ball-on-socket geometry — a metal ball replaces the diseased humeral head and a polyethylene socket replaces the glenoid. It relies on a working rotator cuff to drive movement. A reverse replacement inverts the geometry — the ball is fixed to the shoulder blade and the socket to the upper arm — so the larger deltoid muscle can power the shoulder in patients whose rotator cuff has failed. The choice is made from the X-ray, MRI and the surgeon's examination, and is the most important pre-operative decision.

• How long does a shoulder replacement last?

  Modern shoulder replacements have improved markedly. Australian Orthopaedic Association joint registry data show that around 90% of anatomic total shoulder replacements and reverse replacements are still functioning well at ten years. Longevity beyond fifteen years is increasingly the norm in lower-demand patients. Heavy lifting, contact sport and occupational manual labour shorten implant life and are discussed individually before surgery.

• How much does shoulder replacement cost? What does Medicare cover?

  Shoulder replacement involves separate fees for the surgeon, anaesthetist, assistant, hospital and prosthesis. The practice quotes the surgical fee in writing before the operation is booked — the Medicare item, the rebate and the out-of-pocket gap each shown separately. Dr Hirpara's surgical fees follow the Australian Medical Association schedule, which is higher than the Medicare scheduled fee; the fees page explains why, and what that means for joint-replacement cover under the federal private-health-tier system. Surgery does not proceed without itemised written informed financial consent.

• When can I drive after shoulder replacement?

  Driving requires both arms free of a sling and the ability to control the wheel and indicators safely. For most patients that is around six weeks for an automatic vehicle and a little longer for a manual. The practice does not certify fitness to drive for insurance purposes — driving fitness is a decision between the patient, the GP and the insurer — but the post-operative review at six weeks is the natural point at which the question is discussed.

• Will I be able to sleep on the operated shoulder afterwards?

  For the first six weeks the sling makes side-sleeping on the operated shoulder uncomfortable; most patients sleep on the back or the unaffected side, often slightly propped up. Once the sling comes off and motion is regained, sleeping on the operated side becomes possible again, typically by three to six months. Pre-operative shoulder pain often disturbs sleep more than post-operative recovery does — many patients report sleeping better after surgery than they have for years.

• What activities will I be able to do after a shoulder replacement?

  The aim is a pain-free shoulder with enough range and strength for the activities that matter to the patient — reaching overhead, dressing, gardening, swimming, golf, recreational tennis. Heavy weight-training, repetitive overhead manual work and contact sport are best avoided long-term to preserve the implant. Activities are reintroduced progressively across the first six to nine months, guided by physiotherapy and the post-operative review schedule.

• What are the main risks of shoulder replacement?

  Shoulder replacement is a well-established operation, with Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) data showing around 90% of anatomic total and reverse replacements functioning well at ten years. No surgery is risk-free. The most clinically important risks are infection (uncommon but serious; controlled with strict peri-operative protocols), nerve injury (most often a temporary axillary nerve neuropraxia), dislocation (more common in reverse replacements and addressed with sling protocol compliance), and loosening of the components over time. The practice discusses individualised risk in writing before consent — risk varies with age, cuff status, bone quality and general health.

More general questions about appointments, fees and the practice on the FAQ page.