Shoulder Surgery at OSI
OSI surgeons perform shoulder surgery from arthroscopic rotator cuff and labral repair to anatomic and reverse shoulder replacement. The procedure is matched to your diagnosis and goals, and the surgeon who recommends it performs it.
Shoulder operations are performed at our partner hospitals across the region, with follow-up at any of our six clinic locations. For information on shoulder conditions, evaluation, and non-operative treatment, see Shoulder Care at OSI, or browse the full list of shoulder conditions.
Rotator Cuff Repair
Rotator cuff repair is one of the most common shoulder surgeries we perform. The goal is to reattach a torn tendon to the top of the arm bone so it can heal and resume its role in stabilizing and moving the shoulder. Most repairs are done arthroscopically (through small incisions with a camera), though large or complex tears sometimes require a small open incision for adequate fixation.
The torn tendon edge is mobilized, the bone surface is prepared to promote healing, and the tendon is secured back to its footprint with suture anchors. The repair itself takes roughly an hour. Recovery is the longer commitment: the arm is protected in a sling for four to six weeks while the tendon heals to bone, then motion is gradually restored, and strengthening begins around three months. Full recovery takes four to six months for most patients, longer for large or retracted tears.
Not every rotator cuff tear requires repair. The decision depends on tear size, tissue quality, patient age and activity level, and how much the tear affects daily function. Partial tears and small full-thickness tears in lower-demand patients often do well with physical therapy alone. Your surgeon will explain where your tear falls on that spectrum and why surgery is or is not the right recommendation.
Shoulder Replacement
Shoulder replacement is the definitive treatment for end-stage shoulder arthritis that has not responded to conservative care. Two types of replacement are available, and the choice depends on the condition of your rotator cuff.
Total shoulder replacement (anatomic)
Anatomic total shoulder replacement replaces the ball with a metal component and resurfaces the socket with a smooth plastic component. It restores the normal anatomy of the joint and works best when the rotator cuff is intact, because the cuff muscles still need to center the ball in the socket and power shoulder motion. Pain relief is typically excellent, and most patients regain a functional arc of motion that allows them to return to daily activities, golf, swimming, and low-impact recreation.
Reverse shoulder replacement
Reverse shoulder replacement flips the normal anatomy: a metal ball is placed on the socket side and a socket is placed on the arm side. This changes the mechanics so the deltoid muscle (rather than the rotator cuff) powers overhead motion. Reverse replacement is the option when the rotator cuff is torn beyond repair, because it allows the shoulder to function even without a functioning cuff. It is also used for certain complex fractures in older patients and for failed previous shoulder operations.
Both types of shoulder replacement are done through an incision at the front of the shoulder and take roughly 90 minutes. Most patients go home the same day or the following morning, begin supervised motion within a week, and use a sling for four to six weeks. Full recovery takes three to six months.
Instability and Labral Surgery
Recurrent shoulder instability, where the shoulder continues to subluxate or dislocate despite rehabilitation, usually requires surgery to restore the structural restraints that are keeping the ball from staying in the socket.
Bankart repair
Arthroscopic Bankart repair reattaches the torn anterior labrum and capsule to the front of the glenoid using suture anchors. It is the standard procedure for first-time or early recurrent anterior instability when bone loss is minimal. The operation restores the bumper effect of the labrum and retensions the stretched capsular ligaments. Recovery involves a sling for four to six weeks, a gradual return to motion, and avoidance of contact sports for four to six months.
Latarjet procedure
The Latarjet procedure is a bone-transfer operation used when the front of the socket has been worn away by repeated dislocations, or when a previous Bankart repair has failed. A small piece of bone from near the shoulder is moved to the front of the socket and fixed with screws, rebuilding the rim and adding support across the front of the joint. It has a very low rate of repeat dislocation and is often chosen as the first operation for higher-risk patients, such as contact athletes or those with worn-away bone.
Labrum and SLAP repair
Arthroscopic labral repair addresses tears of the superior labrum (SLAP tears) and other labral pathology that does not fall into the classic anterior Bankart pattern. The indication for SLAP repair has narrowed over the past decade; in younger, active patients with a clear mechanical tear pattern, repair can eliminate catching, pain, and instability. In older patients or those with degenerative labral changes, a biceps tenodesis often produces a more reliable result.
Biceps Tenodesis
Biceps tenodesis detaches the damaged long head of the biceps tendon from inside the shoulder joint and reattaches it to the upper arm bone with a screw or anchor. It removes the biceps as a source of pain while preserving arm strength and appearance. The procedure is frequently performed in combination with rotator cuff repair, since biceps pathology and rotator cuff disease often coexist. It is also the preferred treatment for symptomatic SLAP tears in patients over 40. Recovery is relatively quick: a sling for two to four weeks, with a return to full activity by three months.
AC Joint Reconstruction
AC joint reconstruction addresses high-grade acromioclavicular separations where the clavicle has displaced significantly from the acromion. The procedure reduces the clavicle back to its normal position and stabilizes it with a combination of suture, graft, or suspensory fixation while the ligaments heal. The specific technique depends on how long ago the injury occurred (acute vs. chronic) and the degree of displacement. Recovery involves a sling for six weeks and avoidance of heavy lifting for three to four months.
Pectoralis Major Repair
Pectoralis major repair reattaches the pectoralis major tendon to the humerus after a rupture. This injury occurs almost exclusively in young men during bench press or similar heavy pushing activity. The tendon tears off the bone, producing bruising across the chest and upper arm and a visible dent at the front of the armpit. Surgical repair, when performed within a few weeks of injury, restores strength and contour. The procedure takes about an hour, and the arm is protected in a sling for six weeks, with a gradual return to strength training over four to six months.
Shoulder Fracture Surgery
Fractures around the shoulder are common injuries from falls, cycling crashes, and contact sports. The fracture pattern and displacement determine whether surgery is needed and what type.
Clavicle fractures are the most common shoulder fracture. Many heal without surgery, but displaced midshaft fractures that are significantly shortened or broken into several pieces benefit from plate fixation (ORIF), which restores length and alignment and allows earlier return to activity.
Proximal humerus fractures involve the top of the arm bone near the shoulder joint. Nondisplaced fractures heal in a sling; displaced or multi-part fractures may require plate fixation, and badly shattered fractures in older patients may be best treated with reverse shoulder replacement.
Humeral shaft fractures are typically treated non-operatively with a functional brace, but fractures that fail to heal or that are significantly displaced may require plate fixation or intramedullary nailing.
Scapula fractures are uncommon and usually result from high-energy trauma. Most heal without surgery. Fractures that extend into the socket surface or that significantly alter shoulder mechanics may require surgical fixation.
For the full picture on fracture care across all regions, see Fracture & Trauma Care at OSI.
All Shoulder Procedures We Perform
Rotator cuff & tendon
Joint replacement
Instability & labrum
AC joint
Fracture fixation
What does surgery day look like?
Most shoulder surgery here is arthroscopic and outpatient: you come in, have the procedure, and go home the same day in a sling. Before surgery, the anesthesiologist places a nerve block that usually keeps the arm numb into the night, so start the pain medicine before the block wears off. Shoulder replacement patients may stay one night. You leave with written instructions, sling rules, and a plan for the first follow-up visit. Someone needs to drive you home.
What does recovery look like?
Recovery timelines vary by procedure and by patient. Your surgeon will give you the specific milestones and restrictions for your operation.
Recovery is a structured progression: protection while the tissues heal, then passive motion, then active motion, then strengthening, then sport- or task-specific training. Skipping phases or pushing too fast risks re-injury. Your surgeon will give you specific milestones and restrictions for each phase, adjusted based on how the shoulder is actually responding.
Who will you see?
All three of our board-certified orthopedic surgeons perform shoulder surgery. Meet our providers.
