What is total shoulder resurfacing?

Total shoulder resurfacing (TSR) caps the worn surfaces of the shoulder joint instead of removing and replacing them with a stemmed implant. It is less invasive than conventional total shoulder arthroplasty (TSA), preserves more of your native bone, and allows a faster recovery.

How is TSR different from total shoulder arthroplasty (TSA)?

TSA removes and replaces the joint surfaces with cemented metal and plastic components. TSR resurfaces the existing joint with a press-fit cap and a bone-sparing glenoid implant, which preserves bone and makes future revision easier.

Who is a candidate for total shoulder resurfacing?

TSR is well suited to patients in the 30–50 age range and active patients over 60 with advanced glenohumeral arthritis. Imaging and a focused exam confirm whether enough healthy bone remains to support resurfacing.

Is total shoulder resurfacing outpatient?

Yes. TSR is performed on an outpatient basis, and most patients go home the same day.

How long is recovery after TSR?

Full recovery, including a structured physical therapy program, typically takes 8–12 weeks. After recovery, there are no long-term activity restrictions of the kind imposed after conventional TSA.

Will I still be able to play sports?

Yes — that's one of the main reasons TSR is chosen over TSA for active patients. After recovery, patients routinely return to golf, tennis, swimming, weight training, and other recreational sports.

Shoulder Care

Total Shoulder Resurfacing

A bone-preserving alternative to traditional shoulder replacement.

Book Consultation 614-526-2150

Board-Certified

20+ yrs

Fellowship Trained

Sports Med

Location

Dublin, OH

Approach

Minimally Invasive

Overview

An approach built around your anatomy.

Total shoulder resurfacing (TSR) is an alternative to conventional total shoulder arthroplasty (TSA). It is well suited to younger patients — and to active patients over 60 — who have advanced glenohumeral arthritis that has stopped responding to non-operative treatment.

TSR preserves significantly more native bone than TSA. It is an outpatient procedure with a faster path back to physical therapy and full activity, and it keeps the option of conventional shoulder replacement open later in life if it is ever needed.

Advantage Orthopedics

Dr. Thomas Kovack, M.D.

How TSR differs from a traditional shoulder replacement

Conventional total shoulder arthroplasty reams down the arthritic glenoid socket, cements in a new plastic socket, and replaces the top of the humerus with a metal ball on a stem. Implants last 15–20 years and reliably reduce pain in older, lower-demand patients.

The trade-off is bone loss. If you have TSA in your 50s, there may not be enough humeral bone left for a successful revision down the road. For active patients in the 30–50 range — or active patients over 60 — that's a real concern.

What TSR involves

TSR has two parts. For humeral head resurfacing (HHR), Dr. Kovack uses a custom-fit metal cap that presses onto the top of the humerus. The bone grows into the cap, forming a union that is stronger than the cement used in TSA.

For glenoid resurfacing (GR), Dr. Kovack uses either a plastic inlay implant that sits inside the bone or a fresh osteochondral allograft from a donor. Both maximize bone preservation. Dr. Kovack discusses which option is right for you at your consultation.

Scope of Care

What we treat, and how we treat it.

Conditions Treated5

What we treat

Advanced glenohumeral osteoarthritis in active patients aged 30–50
Advanced glenohumeral arthritis in active patients over 60
Post-traumatic shoulder arthritis
Avascular necrosis of the humeral head
Failed prior shoulder surgery in active patients who want to preserve bone

Procedures Offered4

How we treat it

Humeral head resurfacing (HHR) with custom-fit metal cap
Glenoid resurfacing (GR) with plastic inlay implant
Glenoid resurfacing with fresh osteochondral allograft
Combined HHR + GR (full TSR)

Recovery & What to Expect

TSR is performed on an outpatient basis. Full recovery, including a structured physical therapy program, takes about 8–12 weeks — after which most patients return to full activity without the long-term activity restrictions typical of conventional shoulder replacement.

Frequently Asked Questions

Total Shoulder Resurfacing — answers to common questions.

What is total shoulder resurfacing?: Total shoulder resurfacing (TSR) caps the worn surfaces of the shoulder joint instead of removing and replacing them with a stemmed implant. It is less invasive than conventional total shoulder arthroplasty (TSA), preserves more of your native bone, and allows a faster recovery.
How is TSR different from total shoulder arthroplasty (TSA)?: TSA removes and replaces the joint surfaces with cemented metal and plastic components. TSR resurfaces the existing joint with a press-fit cap and a bone-sparing glenoid implant, which preserves bone and makes future revision easier.
Who is a candidate for total shoulder resurfacing?: TSR is well suited to patients in the 30–50 age range and active patients over 60 with advanced glenohumeral arthritis. Imaging and a focused exam confirm whether enough healthy bone remains to support resurfacing.
Is total shoulder resurfacing outpatient?: Yes. TSR is performed on an outpatient basis, and most patients go home the same day.
How long is recovery after TSR?: Full recovery, including a structured physical therapy program, typically takes 8–12 weeks. After recovery, there are no long-term activity restrictions of the kind imposed after conventional TSA.
Will I still be able to play sports?: Yes — that's one of the main reasons TSR is chosen over TSA for active patients. After recovery, patients routinely return to golf, tennis, swimming, weight training, and other recreational sports.