Anatomic Shoulder Arthroplasty · InSet® Total Shoulder System
Total Shoulder Replacement in Salt Lake City & Park City, Utah
When arthritis has worn through the cartilage of the shoulder but the rotator cuff is still strong, an anatomic total shoulder replacement can rebuild the joint in its natural shape. Dr. Daniel Hatch resurfaces both the ball and the socket using the InSet® Total Shoulder System, helping patients across Park City, Heber City, and Salt Lake City get back to moving comfortably.
Goals of Total Shoulder Replacement
Patients often choose anatomic replacement for:
- An end to the deep arthritic ache, including the pain that wakes them at night
- Easier reach for everyday tasks like putting on a jacket, washing their hair, or lifting a bag into the overhead bin
- A return to the activities that keep them in the mountains, from golf and hiking to cycling and fly fishing
- A modern implant shaped to match their own anatomy
- A bone-conserving design that keeps future options open
A Quick Look at Shoulder Anatomy
Three bones meet at the shoulder: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). The rounded top of the humerus rests against a small, shallow cup on the shoulder blade called the glenoid. Healthy cartilage coats both surfaces so they slide without friction. Around the joint, the four tendons of the rotator cuff keep the ball seated in the socket while the deltoid muscle provides much of the power to lift the arm.
What Leads to an Anatomic Replacement
Once the cartilage is gone, bone grinds against bone and the shoulder becomes stiff and painful. An anatomic replacement is designed for that situation when the rotator cuff remains healthy. The conditions Dr. Hatch most often treats this way are:
- Osteoarthritis: gradual, age-related cartilage loss and the leading reason for shoulder replacement
- Inflammatory arthritis: including rheumatoid arthritis, where inflammation of the joint lining erodes cartilage over time
- Post-traumatic arthritis: joint damage that shows up years after a fracture or dislocation
- Avascular necrosis: loss of blood supply that causes part of the humeral head to soften and collapse
Trying Nonsurgical Care First
Before recommending surgery, Dr. Hatch typically works through therapy to maintain motion, adjustments to how you use the arm, anti-inflammatory medication, and sometimes a cortisone injection. Many people get years of good use from these steps. Replacement may make sense when the pain and stiffness keep coming back and start costing you sleep, independence, work, or the recreation you care about.
Anatomic Replacement and Its Alternatives
- Standard anatomic total shoulder replacement: a new humeral head paired with a resurfaced glenoid, keeping the joint in its natural arrangement
- Stemless anatomic replacement: the humeral head is anchored near the top of the arm bone without a stem in the canal, conserving bone
- Reverse shoulder replacement: generally the better choice when the rotator cuff is torn beyond repair. See reverse shoulder replacement
The Implant
The InSet® Total Shoulder System
For anatomic replacement, Dr. Hatch uses the InSet® Total Shoulder System from Shoulder Innovations. It comes in both short-stem and stemless versions, so the humeral side can be tailored to the quality of your bone and the shape of your shoulder.
Built Around the Socket
Historically, the glenoid component has been the weak link in total shoulder replacement. Conventional designs sit on the face of the socket, and over many years of use that surface fixation can work loose, which is a leading reason anatomic replacements need revision. The InSet® glenoid is instead recessed into a precisely milled pocket in the socket bone. Sitting inside the bone rather than on it is intended to limit the rocking forces that contribute to loosening.
Designed for Bone Ingrowth
The InSet® humeral components have a textured, porous titanium surface that gives your bone something to grow into, so the implant is designed to become more firmly anchored as you heal. Because the system conserves bone, the humeral piece can often be left in place and converted to a reverse configuration if your shoulder ever needs another operation down the road.
The InSet® anatomic total shoulder implant, offered in short-stem and stemless versions.
The InSet® glenoid sits within the socket bone instead of on its surface.
A 3D surgical plan built from your CT scan maps implant size and position in advance.
Precision
Mapping Your Surgery in 3D
How accurately the implant is positioned has a lot to do with how well a replacement works and how long it lasts. For many patients, Dr. Hatch uploads a CT scan into planning software that recreates the shoulder in three dimensions. Working on that model, he selects the implant size and sets its exact angle and depth before surgery begins, which is intended to support a more efficient operation and a joint rebuilt closer to your own anatomy.
Getting Ready for Surgery
After you decide to move forward, our team coordinates the details: imaging for planning, a pre-operative medical check, and a review of your medications. Quitting tobacco ahead of time can make a difference in healing. You will get written instructions about eating and drinking the night before, a skin-cleansing routine for the shoulder, and what to bring. Button-front or zip-up shirts make the first few weeks much easier.
The Day of Surgery
You will receive general anesthesia, and many patients also get a nerve block that keeps the arm numb well into the evening. The replacement itself usually takes one to two hours. You will wake up in a sling, and before discharge you will learn your first exercises along with how to manage the sling, dressing, and daily routines. Many patients head home the same day, while some stay overnight.
What Recovery Looks Like
Dr. Hatch’s team adjusts each recovery to the individual using his Total Shoulder Arthroplasty protocol. A typical progression looks like this:
- Weeks 0 to 2: the sling protects healing tissue while you do pendulum swings and move the elbow, wrist, and hand; some people notice early on that the arthritic ache has eased
- Weeks 2 to 6: light use of the arm returns for meals, writing, and getting dressed as therapy steadily restores range of motion
- Weeks 6 to 12: the sling is retired and strengthening begins; driving, cooking, and most household chores are back
- Months 3 to 12: strength and stamina continue to build, and many patients have returned to the activities they had set aside
Sticking with your therapy program is the biggest factor you control in how well your new shoulder performs.
Risks to Consider
Serious problems after anatomic shoulder replacement are uncommon, but every surgery carries risk. These include anesthesia reactions, infection, bleeding, injury to nerves or blood vessels, stiffness, fracture, gradual wear or loosening of the implant, and the chance of a future revision. Dr. Hatch will review your personal risk factors in detail, and protocols for antibiotics, blood clot prevention, and pre-operative optimization are in place to keep those risks low. Results vary.
Frequently Asked Questions
How long can a total shoulder replacement last?
Anatomic shoulder replacement has a strong long-term record, and many patients do well with their new shoulder for more than ten years. A stable socket component is an important factor in how long an implant lasts, which is one reason Dr. Hatch uses the InSet® glenoid. Individual results vary.
How much pain should I expect after surgery?
Soreness peaks in the first week or two and is managed with a nerve block, medication, and ice. Many patients notice the arthritic pain they had before surgery eases quickly, and the incisional soreness fades steadily after that.
Can I go home the same day?
Many healthy patients do. Dr. Hatch will recommend same-day or overnight care based on your medical history and the help you have at home.
When can I drive, golf, or ski again?
Desk work often resumes within a few weeks. Driving usually resumes once you are out of the sling (often around six weeks) and off narcotic pain medication. Golf and swimming generally return around three months. Skiing depends on your strength and balance and is a decision you and Dr. Hatch make together, often by the next season.
How is a total different from a reverse replacement?
An anatomic total shoulder replacement preserves the joint’s natural arrangement and depends on a healthy rotator cuff. A reverse replacement swaps the ball and socket so the deltoid can lift the arm when the cuff is beyond repair. The shoulder replacement overview compares the two.
Schedule a Total Shoulder Replacement Consultation
Call or text the office, or request an appointment online, and our team will help you take the first step toward a shoulder that moves comfortably again.