Shoulder arthroscopy is a minimally invasive, “keyhole” surgical technique used to diagnose and treat a wide range of shoulder problems. Through small incisions, a high-definition camera and specialized instruments are inserted into the shoulder joint, allowing the surgeon to clearly visualize internal structures and perform precise repairs.
This modern approach is routinely used to examine and treat the glenohumeral joint, acromioclavicular (AC) joint, and the subacromial space. Many conditions that once required large incisions can now be treated arthroscopically, including rotator cuff repairs, instability surgery, ligament injuries, and subacromial decompression.
Compared to traditional open surgery, arthroscopic shoulder procedures offer several significant advantages:
Minimal scarring due to tiny incisions
Less muscle damage, as major tissues are not cut
Clear, magnified view of internal structures
Better access to areas difficult to reach with open surgery
Lower infection risk, as the incisions are small
Reduced bleeding and nerve injury risk
Faster recovery, allowing earlier rehabilitation
Advances in arthroscopic instruments and implants now allow surgeons to perform stable, durable repairs with outcomes that often match—or even exceed—those of open techniques.
Depending on the surgical approach required, the patient may be positioned lying on their side or in a semi-sitting “beach chair” position.
Small incisions (portals) are made around the shoulder through which the arthroscope (camera) and surgical tools are introduced. Throughout the procedure, sterile saline fluid flows through the joint, gently expanding the space and providing a clear view.
Some of this fluid is absorbed by the surrounding tissues, which may temporarily cause swelling in the shoulder region. This swelling reduces over the next few hours, and any remaining fluid drains through the incision sites. A soft padded dressing is applied to absorb this leakage and keep the area clean.
The small incisions created during arthroscopy typically heal beautifully and fade significantly over time, often becoming barely visible.
During shoulder arthroscopy, the surgeon gains a close view of multiple important structures inside the joint:
The labrum, a ring of cartilage that stabilizes the shoulder socket, can be torn during dislocations—commonly in the antero-inferior region, but injuries may occur anywhere around the rim.
The middle glenohumeral ligament (MGHL) appears as a fold in the capsule and tightens as the shoulder rotates outward. Its anatomy varies between individuals.
The subscapularis tendon, part of the rotator cuff, attaches to the front of the humeral head and is responsible for internal rotation of the shoulder.
This tendon originates from the top of the shoulder socket and travels inside the joint before settling into a groove on the front of the humerus. It is a common source of pain in many shoulder problems.
The rotator interval capsule lies between the supraspinatus and subscapularis tendons and is usually thin and flexible. Beneath it sits the coracoid process, a bony structure that is not visible arthroscopically.
By moving the scope over the humeral head, the surgeon can examine the underside of the supraspinatus and infraspinatus tendons—the two tendons most commonly affected in rotator cuff injuries and tears.
Arthroscopic Subacromial Decompression is a minimally invasive, keyhole procedure performed to relieve pain caused by shoulder impingement and rotator cuff tendinopathy. In these conditions, the tissues in the subacromial space become irritated or compressed, leading to persistent pain during lifting, reaching, or overhead activities.
Although this procedure can be very effective for many patients, current evidence suggests that not everyone requires surgery—especially those whose rotator cuff is intact and who may improve with non-surgical options. For this reason, subacromial decompression is generally considered only after physiotherapy, medication, and injections have failed to provide relief.
In many cases, this surgery is performed in combination with other arthroscopic shoulder procedures, such as rotator cuff repair or AC joint excision, to improve visualization and access inside the joint.
The surgery is done under general anesthesia, often combined with a regional nerve block for postoperative comfort.
The arthroscope is first inserted into the shoulder to evaluate the joint surfaces, rotator cuff tendons, and surrounding tissues.
The arthroscope is then advanced into the subacromial space, located between the rotator cuff tendons below and the acromion bone above. This area is commonly inflamed in impingement syndromes.
The surgeon removes the thickened, inflamed bursal tissue.
This step helps by:
Eliminating pain-sensitive nerve endings
Creating a clearer view of the space
Improving access for further treatment
Some patients have a hooked or prominent acromion or a thickened ligament at the front of the shoulder. These can rub against the rotator cuff, causing pain.
Using a high-speed burr, the surgeon carefully smoothens the spur and trims any irritated ligament tissue.
This increases the space above the rotator cuff and reduces mechanical irritation.
The fresh bone surface may also stimulate biological healing, improving the environment for tendon recovery.
Most patients return home a few hours after surgery.
Take prescribed pain medications as instructed, ideally before the nerve block wears off.
A sling may be provided, but usually only needed for comfort for a few days.
Bulky dressings can be removed after Day 2, but waterproof dressings should remain for around 12 days.
Showering is allowed after 4 days while keeping dressings dry.
As no tissues are repaired during this procedure, early movement is encouraged.
Start gentle exercises as soon as comfortable.
Physiotherapy focuses first on restoring movement, then on rebuilding strength and shoulder control.
Consistent rehabilitation plays a major role in achieving optimal results.
Recovery varies from person to person, but commonly:
Office work: around 3 weeks (some may need longer)
Light physical work: around 8 weeks
Heavy labour or overhead sports: up to 18 weeks
Driving: typically 3–8 weeks depending on comfort and control
Most patients experience significant improvement, though the timeline can vary:
By 6 weeks: Around 60% notice meaningful pain relief and improved daily function, though some movements may still be uncomfortable.
By 6 months: Approximately 90% report major improvement.
Some individuals may continue improving for up to 9 months after surgery.
Arthroscopic shoulder surgery is generally safe, but potential risks include:
Stiffness (about 5%), occasionally requiring additional treatment
Incomplete relief (around 10%), especially in cases with long-standing symptoms
Most complications are rare, and choosing a skilled arthroscopic surgeon helps minimize these risks.
Arthroscopic Rotator Cuff Repair is a minimally invasive procedure used to fix tears in the rotator cuff tendons of the shoulder. Using tiny incisions, a high-definition camera, and fine surgical instruments, the torn tendon is reattached securely to the bone, restoring strength, movement, and shoulder stability.
Modern arthroscopic techniques allow surgeons to perform strong, durable repairs while causing minimal disruption to surrounding tissues.
During the procedure, specially designed sutures and anchors are used to reattach the tendon:
Strong suture tapes are passed through the torn tendon tissue.
These sutures are then brought out through small portals and attached to bone anchors placed in the humeral head.
The repair is tightened to compress the tendon securely against its natural attachment site (the “footprint”).
This creates a stable, anatomical repair, giving the tendon the best possible chance to heal.
Often, multiple rows of sutures are used in a “bridge” configuration to provide powerful compression and long-term repair strength.
Most patients go home on the same day or the following morning. A nerve block may be used to keep the shoulder numb for several hours after surgery.
Start your prescribed pain medication before the nerve block wears off and continue regularly for a few days.
A sling is required for 4–6 weeks to protect the repaired tendon.
Your surgeon and physiotherapist will advise which movements to avoid during this period.
Bulky dressings can be removed after 48 hours.
Keep the smaller waterproof dressings for 12 days.
Showering is allowed after 4 days while keeping dressings in place.
Stitches (if present) are removed after 12–14 days.
Recovery after rotator cuff repair follows a structured plan:
Repair protection using a sling
Limited and guided shoulder movement
Gradual return of shoulder motion
Improving control and flexibility
Strengthening shoulder muscles
Functional and sport-specific training
Gradual return to daily activities and fitness
Recovery time varies based on tear size, tissue quality, and patient effort with physiotherapy. General expectations:
Office work: 2–4 weeks (while wearing a sling)
Light physical work: around 12 weeks
Heavy labour / sports: up to 6 months
Driving: Usually safe around 8 weeks once you can control the wheel confidently
By 6 weeks, many patients feel better with daily tasks, though overhead and outward movements may still be uncomfortable.
By 6 months, 85% of patients notice significant improvement.
Arthroscopic rotator cuff repair is very safe, but some risks exist:
Healing rates typically range between 70% and 90%, depending on:
Tear size and retraction
Tissue quality
Age
Surgical technique
Even if the tendon doesn’t fully heal, many patients still experience pain relief and functional improvement.
A small number of patients may develop postoperative stiffness or frozen shoulder, sometimes requiring:
Physiotherapy
Injections
Rarely, further arthroscopic release
A minority of patients may feel limited benefit, especially if the tear was very large or chronic.
Infection
Significant bleeding
Nerve irritation or injury
These complications are uncommon due to the minimally invasive technique and advanced surgical safety protocols.
Arthroscopic Shoulder Stabilisation is a minimally invasive procedure performed to treat shoulder instability caused by a Bankart tear, labral injury, or recurrent shoulder dislocation. Through tiny keyhole incisions, the surgeon repairs the torn labrum and tightens the stretched capsule, restoring stability and preventing future dislocations.
During the procedure, a high-definition arthroscope provides a clear view of the torn labrum at the front of the shoulder socket (glenoid). Special suture anchors are inserted into the glenoid bone to secure the labrum back to its original position, and the loose capsule is tightened to improve joint support.
Using a small camera inserted from the back of the shoulder, the surgeon examines the front of the socket where the labrum has detached. A Bankart lesion may involve a large portion of the labrum.
High-strength suture tapes are carefully passed around the torn labrum.
A small drill hole is created at the edge of the socket to hold an anchor.
The sutures are threaded through a knotless anchor, which is then inserted into the drilled socket.
This firmly reattaches the torn labrum to the glenoid rim.
The restored labrum again forms a tight seal around the socket, helping keep the shoulder joint stable.
The tightened inferior capsule further reduces the risk of repeated dislocation.
A suture anchor is a small medical implant designed to secure sutures into bone. During shoulder stabilisation:
Sutures are passed through the torn labral tissue
These sutures are then fed through a tiny eyelet in the anchor
The anchor is placed into a drilled socket in the bone
No knots are tied inside the joint, reducing the chance of rubbing or irritation
Most modern anchors are biocomposite, meaning they are gradually replaced by natural bone over time. The suture tapes used are extremely strong and designed to grip tissue securely without cutting through it.
Most patients return home a few hours after surgery and will be provided with a sling to protect the repair.
Recovery follows three structured phases:
Sling worn full-time as instructed
Only basic, guided exercises allowed
Movements that could stress the repair must be avoided
Gradual removal of the sling
Active range-of-motion exercises begin
Focus on rebuilding shoulder control and coordination
Progressive strengthening program
Targeted exercises to prepare for daily function, work, and sports
Return to full activity based on healing and physiotherapy progress
While progress varies between individuals, general guidelines include:
Office work: ~2 weeks (with sling)
Light physical work: ~12 weeks
Heavy labour: 18–24 weeks
Contact sports: at least 6 months
Driving: usually safe around 6–8 weeks
By six months, 85–90% of patients feel confident and secure in their shoulder, though functional improvement may continue for up to a year.
Arthroscopic stabilisation is very safe, but potential risks include:
The shoulder may become unstable again, especially in:
Young athletes
Contact sports players
Patients with multiple pre-surgery dislocations
Usually improves with physiotherapy and time without the need for further surgery.
Some patients may notice occasional aches despite a stable and functional shoulder.
Serious complications such as infections, nerve injuries, or significant bleeding are very rare.
Arthroscopic Capsular Release is a minimally invasive surgical procedure used for patients with Frozen Shoulder (Adhesive Capsulitis) who do not respond to physiotherapy, medications, or injections. The surgery is performed under general anesthesia along with a regional nerve block to ensure comfort.
This procedure combines two important steps:
Together, these steps help restore shoulder mobility, reduce pain, and prevent recurrence of stiffness.
Through small keyhole incisions, a camera and fine surgical instruments are inserted into the shoulder.
The surgeon begins by clearing the rotator interval, an area at the front of the shoulder where the capsule often becomes thickened and inflamed.
Next, the superior capsule is released beneath the rotator cuff tendons.
A partial release of the anterior–inferior capsule is then performed to create a controlled area of weakness.
This strategic release helps guide the capsule to safely loosen during manipulation, reducing the risk of injury to the shoulder structures.
After completing the arthroscopic portion, the arthroscope is removed.
The surgeon gently takes the shoulder through a series of movements with controlled force to break the remaining tight portions of the capsule.
This combination helps restore range of motion while minimizing trauma to surrounding tissues.
Most patients stay overnight in the hospital.
This allows the arm to rest in an elevated sling and provides time for the physiotherapy team to review early exercises before discharge.
Begin your prescribed pain medications before the nerve block wears off.
Continue taking them regularly for the first few days.
You can stop using the sling after a few days, as early movement is important to prevent stiffness from returning.
Bulky dressings may be removed on Day 3.
Waterproof dressings must remain for 12 days.
Showering is allowed after 4 days, as long as dressings are firmly sealed.
Recovery varies depending on pain and rehabilitation progress, but typical timelines include:
Office work: around 2 weeks if pain is manageable
Light physical activity: approximately 6 weeks
Heavy labour or overhead sports: may take longer depending on shoulder recovery
Driving: safe once you can confidently control the steering wheel—usually after a few weeks
Physiotherapy is essential following this procedure.
Early and consistent exercises prevent the capsule from tightening again as healing begins.
You will be seen by a physiotherapist before leaving the hospital, and a structured rehabilitation plan will be arranged for ongoing therapy.
Regular follow-up visits monitor healing and progress:
First review at 2 weeks
Subsequent visits tailored to your progress
Many patients can be discharged from further follow-up by 3 months
Arthroscopic capsular release is highly effective for most patients.
85% experience substantial improvement in pain and shoulder motion
A small percentage may require additional treatment
Individuals with diabetes often require a more prolonged recovery, as they are more prone to persistent stiffness
While frozen shoulder rarely recurs in the same joint, there is a 30–40% chance of developing it in the opposite shoulder at some point in the future.
The procedure is generally very safe, but rare complications may include:
Bleeding
Infection
Nerve injury
Fracture of the upper arm (humerus)
Injury to internal joint structures
These risks are minimized when the procedure is performed by an experienced arthroscopic surgeon.
Arthroscopic management of shoulder degeneration is a minimally invasive treatment designed to reduce pain and improve shoulder function in patients with early to moderate arthritis. It is often recommended for individuals who are not yet ideal candidates for joint replacement surgery, particularly those below 60 years of age.
Some surgeons refer to this comprehensive approach as a CAM (Comprehensive/Complete Articular Management) procedure, as it targets multiple sources of pain within the shoulder.
The surgery is carried out under general anesthesia, often combined with a regional nerve block to enhance comfort.
Most patients are treated as day-care cases, though an overnight stay may occasionally be required.
This is a keyhole (arthroscopic) procedure, involving several tiny incisions (usually less than 1 cm).
A slightly larger incision (around 3 cm) may be needed if a biceps tenodesis is performed.
The goal of arthroscopic management is to address all possible pain generators within the shoulder. Depending on the clinical findings, your surgeon may perform one or more of the following procedures:
Treatment of inflammation or tearing of the biceps tendon inside the shoulder.
Shaving off osteophytes from the joint surfaces to reduce friction and pain.
Trimming unstable or frayed cartilage edges to prevent further wear.
Creating small holes in exposed bone to stimulate healing tissue where cartilage is lacking.
Clearing inflamed joint lining (synovium) that contributes to pain.
Removing thickened bursa and excess bone under the acromion to improve shoulder clearance.
If the AC joint is arthritic and painful, part of the bone is removed to relieve discomfort.
Each step is tailored to the patient’s specific joint condition.
Take prescribed pain medications regularly for the first few days.
A sling will be provided, but you may remove it as soon as you feel comfortable unless instructed otherwise.
Begin physiotherapy and guided exercises early to prevent stiffness.
Bulky dressings may be removed on Day 2.
Keep the wounds clean, dry, and covered for 12 days.
Showering is allowed after 4 days if waterproof dressings are intact.
Recovery depends on the extent of degeneration and whether additional repairs (such as cuff repair or biceps surgery) were performed:
Office/Desk Work: 2–4 weeks
Light Physical Work: 6–12 weeks
Heavy Manual Labour: 16–24 weeks (longer if a repair was done)
Driving: Once you can confidently control the car—typically after 4+ weeks
Most patients begin to notice improvement within weeks, and:
By 6 months, about 75% of patients experience significant symptom relief.
You will be reviewed approximately 2 weeks after surgery to assess healing.
Further appointments will be scheduled based on your progress and symptom improvement.
Arthroscopic shoulder surgery is considered safe, but as with any procedure, there are some risks:
May require further physiotherapy or, rarely, another procedure.
A visible bulge in the upper arm after:
Biceps Tenotomy: ~40% risk
Tenodesis: ~5% risk
This occurs when the biceps muscle drops slightly lower.
Approximately 25% of patients may not experience full symptom improvement, especially with advanced arthritis.
Bone spur removal near the axillary nerve carries a small risk of injury, which may cause weakness of the deltoid muscle.
Injuries to the acromioclavicular (AC) joint can cause pain, deformity, and instability around the upper shoulder. The ideal surgical approach depends largely on how recent the injury is.
Acute injuries (within 4 weeks) can often be treated using minimally invasive arthroscopy.
Chronic or long-standing cases typically need an open reconstruction, as the damaged ligaments no longer have the capacity to heal.
Both procedures are usually performed under general anesthesia, often combined with a regional nerve block for postoperative comfort. Most patients return home the same day or the following morning.
For injuries that are less than four weeks old, a keyhole repair may restore joint stability effectively.
Three tiny arthroscopy portals are created around the shoulder.
A small (approx. 2 cm) incision is made over the collarbone to assist in fixation.
Strong suture tapes are threaded through drilled tunnels in the clavicle and coracoid process.
These sutures are secured using small titanium buttons, pulling the clavicle back into its normal alignment.
The sutures act as a temporary internal support while the natural coracoclavicular ligaments heal.
When injury is older or when ligaments are too damaged to repair, an open reconstruction is required.
A small incision is made on the top of the shoulder for access.
The outer end of the collarbone is exposed; damaged bone may be trimmed to restore smooth alignment.
The coracoid process is accessed by gently elevating a portion of the deltoid muscle.
A durable synthetic graft (such as a polyester/LARS ligament) is looped beneath the coracoid and fixed to the clavicle using screws.
Additional fiber-tape or an internal brace may be used to reinforce stability from front to back.
This reconstruction recreates the function of the original coracoclavicular ligaments.
Most patients are discharged the same day or the next morning.
Pain medication is recommended regularly for the first few days.
A sling is required:
4 weeks for arthroscopic repairs
6 weeks for open reconstructions (to allow deltoid healing)
Bulky dressings can be removed on Day 3.
Waterproof dressings should remain for 12 days.
Showering:
After 4 days for arthroscopic repairs
After 14 days for open procedures (to keep incision dry)
Office/desk work: 2–4 weeks
Light physical activities: ~12 weeks
Heavy labor or overhead sports: 16–24 weeks
Driving: ~6 weeks, once safely able to control the vehicle
Most patients (around 90%) notice significant improvement, although full recovery may take several months.
First follow-up: 2 weeks after surgery with an X-ray to check alignment.
Subsequent visits depend on healing progress.
Most patients complete follow-up by 6 months.
AC joint surgeries are generally safe, but possible complications include:
May improve with physiotherapy; rarely requires further surgery.
A small bump or step-off at the AC joint may appear as implants settle—usually not functionally significant.
A small number may require revision surgery due to recurrent instability.
May require antibiotics or additional procedures in rare cases.
The coracoid lies near important nerves and vessels, making very rare injury possible.
Occasionally these narrow bones may erode or, rarely, fracture during or after reconstruction.
Choosing the right approach for an AC joint injury requires a clear understanding of the options. During consultation, the surgeon will explain the procedure, expected outcomes, and any concerns you may have so you can make a confident decision about your treatment
Acromioclavicular joint excision—also called distal clavicle excision—is a minimally invasive procedure used to relieve pain caused by arthritis or chronic irritation in the AC joint. The surgery is typically performed as a day-care, keyhole procedure under general anesthesia.
The goal of the operation is to remove a small portion (around 5 mm) of the outer end of the collarbone so that the worn joint surfaces no longer rub against each other. During the same session, surgeons often perform a subacromial decompression to further improve shoulder mechanics and reduce irritation.
Using an arthroscope, the surgeon first clears inflamed and degenerated soft tissue from around the AC joint. This exposes the worn bone surfaces that are contributing to the pain.
A high-speed burr is used to carefully shave away a small portion of the distal clavicle. This creates more space between the clavicle and the acromion, preventing painful bone-on-bone contact.
During the resection, the superior AC joint capsule is preserved. This structure is crucial for keeping the joint stable after surgery.
Most patients can leave the hospital a few hours after surgery.
Pain medicines should be taken regularly for the first few days
A sling is provided but can usually be discontinued after a few days
Bulky dressings may be removed on Day 2
Waterproof dressings should stay on for 12 days
Showering is allowed after 4 days with dressings in place
Recovery varies, but most patients follow this general timeline:
Office/desk work: ~2 weeks
Light physical activities: 6–10 weeks
Heavy labour or overhead sports: 12–16 weeks
Driving: Once you can safely control your arm—usually after a few weeks
By around 6 months, 85–90% of patients have significant improvement, although some take longer to reach their best outcome.
Your first check-up typically occurs at 2 weeks to review healing.
Depending on your progress, follow-up continues for 3–6 months.
AC joint excision is a safe procedure, but like all surgeries, some risks exist:
AC joint instability: <5%
Persistent symptoms or limited improvement: <5%
Shoulder stiffness: ~5%
Most complications are uncommon and manageable with early physiotherapy and follow-up care.
Arthroscopic SLAP repair is a minimally invasive keyhole procedure performed under general anesthesia along with a regional nerve block. Through very small incisions—usually less than a centimeter—an arthroscope and specialized instruments are introduced to examine and treat the shoulder joint.
A SLAP tear refers to an injury of the Superior Labrum Anterior to Posterior—the upper rim of the shoulder socket where the long head of the biceps tendon attaches. This region can be injured by:
Sudden pulling or traction on the arm
A fall or impact on the side of the shoulder
Repetitive overhead motions such as throwing, tennis, or weightlifting
Because the superior labrum is closely connected to the biceps tendon, symptoms from both structures can overlap. Depending on the type of SLAP lesion and the patient’s age, different treatment strategies may be recommended.
The decision on the best approach is based on the pattern of the tear, tissue quality, and patient age:
Ideal for younger patients (typically under 35) with repairable labral tears.
Preferred in patients above 35 or when the biceps anchor is significantly damaged.
Shaving and smoothing frayed or degenerative labral tissue—commonly used for older, wear-and-tear type injuries.
During arthroscopy:
The torn superior labrum is gently freed from scar tissue
The upper glenoid bone is prepared using a burr or rasp to encourage healing
The labrum is anchored back to the bone using low-profile, knotless suture anchors to minimize cartilage irritation
These anchors secure the labrum anatomically, helping restore the stability of the shoulder and the function of the biceps tendon.
Most patients are discharged on the same day.
Start prescribed pain medication before the nerve block wears off
A sling is worn for about 6 weeks to protect the repair
Bulky dressings may be removed on Day 2
Waterproof dressings must stay for 12 days
Showering is allowed after 4 days with dressings on
Rehabilitation progresses in stages:
0–6 weeks: Sling use, passive-assisted movements
6–10 weeks: Active range of motion
10+ weeks: Strengthening begins
6 months: Most activity restrictions are lifted
While recovery varies, most patients can expect:
Office/desk work: ~2 weeks (with sling)
Light physical work: ~12 weeks
Heavy labour/sports: 5–6 months
Overhead or contact sports: ~6 months
Driving: Usually around 8 weeks, once safe to control the vehicle
By six months, the majority of patients notice substantial improvement, although mild stiffness can persist for several months.
The first review is typically at 2 weeks. Further appointments depend on recovery, with most patients completing follow-up between 6–12 months.
Although arthroscopic SLAP repair is usually safe, some risks include:
Usually improves with therapy; rarely requires further surgery.
May lead to persistent symptoms; biceps tenodesis is a common revision option.
Occasionally, symptoms continue without a clear cause despite successful healing.
The Latarjet procedure is an open surgical technique used to stabilize shoulders that continue to dislocate due to significant bone loss in the socket (glenoid) following trauma. This surgery is performed under general anesthesia, often combined with a regional nerve block. Most patients return home the same day or stay overnight for observation.
During the operation, an incision is made on the front of the shoulder. The coracoid process, along with the attached tendons, is carefully separated from the shoulder blade. A controlled split is made through the muscles and joint capsule to access the shoulder.
The area of missing bone on the glenoid is prepared to accept the graft. The coracoid bone piece is then passed through the muscle split and fixed to the rim of the socket using two screws. This accomplishes two things:
Rebuilds the missing bone, creating a deeper and more stable socket
Provides a dynamic “sling effect”, as the attached tendons reinforce the front of the joint during movement
The wound is closed using dissolvable sutures.
The concept behind the Latarjet procedure is to restore lost stability through both bone augmentation and muscle support.
A variation, the Eden–Hybinette procedure, uses a bone graft from the iliac crest (hip bone) instead of the coracoid. It is used in cases where the coracoid cannot be used. Both approaches are effective for managing significant bone deficits.
Recovery is gradual and structured to protect the graft while restoring movement and strength.
Sling: Worn for 2–4 weeks
Range of Motion Exercises: Started progressively; near full movement by 6 weeks
Strengthening: Begins around 3 months
Full Activity: Most restrictions lifted by 6 months
Patients typically return to:
Desk/office work: 2–4 weeks
Light physical duties: 8–12 weeks
Heavy manual work: 16–24 weeks
Contact or overhead sports: Around 6 months
Driving: Usually 6–8 weeks once safe control is regained
By six months, more than 90–95% of patients feel confident in their shoulder stability.
2-week visit: Wound check and assessment of early recovery
6-week and 3-month X-rays: To ensure the graft is healing and the screws are positioned appropriately
Further appointments are scheduled depending on recovery progress.
While the Latarjet procedure is highly reliable, certain risks exist:
Most cases improve with therapy.
On rare occasions, screws may become prominent and require removal.
Protection and adherence to activity restrictions help reduce this risk.
Even if the graft does not fuse completely, many patients still achieve stable function.
Displacement of the graft is uncommon but may require revision.
Failure rates are typically below 5% in most studies.
Often manageable with therapy; rarely requires further intervention.
The upper part of the biceps muscle is connected to the shoulder through two tendons.
The short head attaches to the coracoid process outside the joint and rarely causes problems.
The long head travels inside the shoulder joint and anchors at the top of the socket (glenoid).
Because this tendon passes through tight spaces and is exposed to friction, it often becomes inflamed, frayed, or painful, especially in people with shoulder injuries or degeneration.
When conservative treatments are no longer effective, surgery targeting the long head of the biceps can relieve pain. This can be done through either tenotomy or tenodesis, commonly performed alongside arthroscopic procedures such as rotator cuff repair or subacromial decompression. Surgery is carried out under general anesthesia, sometimes with a nerve block for added comfort.
In a tenotomy, the long head of the biceps tendon is simply released from its attachment inside the shoulder. The tendon then retracts naturally out of the joint.
This is a quick, minimally invasive solution that works well for many patients.
Some individuals—especially lean or muscular men—may notice a visible change in the contour of the biceps called a “Popeye” deformity. This does not affect daily function, but some patients may prefer to avoid the cosmetic change or may experience occasional cramping during heavy lifting.
In a tenodesis, the long head tendon is re-anchored to the upper arm bone (humerus) to maintain tension and preserve the normal muscle contour.
This is done through a small incision near the front of the armpit. The tendon is secured to the bone using strong sutures attached to a small implant—either a titanium button or a suture anchor.
Tenodesis is often preferred for younger patients, athletes, or those who perform heavy physical work because it reduces the chance of cramping and prevents the Popeye appearance.
Most patients return home the same day. Recovery progresses in stages:
Sling worn to protect the repair
Pain medication as needed
Wound care: bulky dressing removed after 2 days; waterproof dressing kept for 12 days
Showering allowed after 4 days with dressings on
Sling removed
Gradual restoration of shoulder mobility
Introduction of light functional movements
Progressive strengthening exercises
Gradual return to full activity
Full recovery expected by 6 months
Office work: ~2 weeks
Light physical activity: 8–12 weeks
Heavy labour: 16–24 weeks
Contact sports: around 6 months
Driving: usually 6–8 weeks, once safe vehicle control is regained
Individual recovery may vary based on activity level and associated procedures.
Both surgeries are effective for relieving pain from a damaged long head biceps tendon.
Tenotomy is ideal for:
Older individuals
Patients with lower physical demands
Those wanting a quick, simple procedure
Tenodesis is favored for:
Younger, athletic, or high-demand individuals
Patients concerned about biceps contour
Those who may experience muscle cramping after a tenotomy
Strength outcomes between the two procedures are very similar. Tenodesis has a slightly higher procedure complexity, but also minimizes cosmetic changes.
Patients are typically reviewed:
At 2 weeks for wound check
Again between 3–9 months, depending on healing, symptoms, and activity demands
Biceps surgery is generally very safe. Specific risks include:
Shoulder stiffness (around 5%)
Humeral fracture after tenodesis (very rare)
Nerve irritation or injury — extremely uncommon
Popeye deformity — common after tenotomy, rare after tenodesis
Biceps cramping — occasionally after tenotomy
Scar concerns — uncommon but possible with the small incision used for tenodesis
Most patients recover well and experience significant pain relief after surgery.
Superior Capsular Reconstruction (SCR) is a minimally invasive arthroscopic procedure performed under general anesthesia, often combined with a regional nerve block for comfort.
This technique was originally developed in Japan and is now used worldwide to treat massive, irreparable rotator cuff tears in younger or active individuals. It is particularly useful for patients who continue to have weakness, pain, and poor shoulder function despite dedicated physiotherapy.
In a healthy shoulder, the rotator cuff helps keep the humeral head centered within the socket. When a large tear cannot be repaired, the humeral head tends to drift upward, causing weakness and early cartilage wear. SCR works by placing a graft between the humerus and the glenoid to restore joint balance, allowing the deltoid muscle to lift the arm more effectively and helping protect the remaining joint cartilage.
However, SCR is not appropriate for everyone.
It is generally not recommended for patients with:
Advanced shoulder arthritis
Complete loss of the remaining cuff tendons
Severe joint degeneration
A thorough evaluation is needed to determine if SCR is suitable.
SCR is done entirely through small keyhole incisions.
Arthroscopic Assessment
The surgeon examines the shoulder joint and subacromial space, removing inflamed tissue, scar tissue, and any old sutures from previous surgeries.
Biceps Management
If the long head of the biceps tendon is still intact and contributing to pain, it may be released (tenotomy).
Preparing the Bone Surfaces
The top edge of the glenoid and the greater tuberosity of the humerus are gently smoothened to create an ideal surface for graft healing.
Graft Placement
A strong biological graft—commonly a processed porcine dermal patch—is positioned like a bridge between the socket and the humerus.
Fixation
The graft is secured with multiple suture anchors and then stitched to the remaining posterior rotator cuff to improve stability and restore force balance.
This reconstructed “capsule” helps re-establish proper joint mechanics, making arm elevation easier and reducing pain.
Most patients return home the same day or after an overnight stay. Pain medication is advised for the first few days, ideally before the nerve block wears off.
Bulky dressings can be removed on Day 2
Waterproof dressings remain for 12 days
Showering is fine after 4 days with dressings on
0–6 Weeks:
Sling worn continuously to protect the graft. Only gentle, guided movements allowed.
6–12 Weeks:
Begin active shoulder motion under physiotherapy supervision.
3 Months+:
Structured strengthening exercises start.
6 Months:
Most restrictions lifted; continued improvement expected up to a year.
Desk/office work: 2–3 weeks (with sling)
Light physical work: 12 weeks
Heavy labour / overhead sports: 6 months or more
Driving: After 8 weeks, once safe control is regained
Patients are typically reviewed:
At 2 weeks, then
At intervals tailored to progress
Most individuals complete follow-up by 6 months.
Although SCR is a relatively recent technique, early and mid-term results from international studies are very promising. Many patients experience:
Better shoulder elevation
Reduced pain
Improved day-to-day function
Delayed need for joint replacement
Because it is a newer procedure, long-term data is still being collected through ongoing research studies.
While arthroscopic shoulder surgery is generally safe, specific risks of SCR include:
Stiffness (around 5%) — may require additional therapy or, rarely, further surgery
Limited improvement (10–15%) — full benefits often take 9–12 months
Infection (~1%) — grafts are highly processed and sterile, making this risk very low
Reaction to graft material — extremely rare
Failure of graft healing — may require revision or alternative treatment
Despite these risks, most patients show meaningful improvement in strength and function.
Total Shoulder Replacement is a surgical procedure designed to relieve severe shoulder pain, improve mobility, and restore function when arthritis or joint damage becomes too advanced for conservative treatments. The surgery is performed under general anesthesia, often supported by a regional nerve block to maintain comfort after the procedure. Most patients stay in the hospital for 2–3 days.
During surgery, an incision is made at the front of the shoulder. Tight or scarred tissues are gently released to improve movement, and the damaged joint surfaces are replaced with precisely engineered metal and plastic components to recreate a smooth, pain-free joint.
This is recommended when the rotator cuff tendons are healthy and functioning properly.
The worn-out ball (humeral head) and socket (glenoid) are removed.
They are replaced with implants shaped to match your natural anatomy.
The glenoid (socket) is reconstructed using a strong medical-grade polyethylene implant fixed with pegs and cement.
The humeral head implant is made of cobalt-chrome alloy or ceramic.
Depending on your bone quality, the humeral component may be:
Stemless (supported by small fins that grip the bone), or
Stemmed (a longer component inserted into the bone canal for stability)
This procedure relies heavily on a functional rotator cuff, which helps maintain strength and stability after surgery.
In some cases, only the humeral side of the joint is replaced, while the natural socket is left intact.
Slightly shorter surgical time
Good pain relief for many patients
Useful when the socket is not badly damaged
Although pain relief is reliable, the functional improvement is usually less than with a total shoulder replacement.
Your surgeon will recommend the best option based on your:
Age
Activity demands
Bone quality
Rotator cuff condition
Personal preferences
You will wake up with your arm supported in a sling and temporary numbness due to the nerve block. Pain is managed with medication as the block wears off. After surgery:
X-ray and blood tests are done the next day
A physiotherapist will begin gentle exercises with you
Most patients return home by Day 2
The incision must remain dry and covered for 12 days
Recovery is gradual and requires dedication to physiotherapy.
0–4/6 Weeks:
Wear a sling continuously to protect the repaired subscapularis tendon (one of the rotator cuff muscles that must be temporarily detached during surgery).
6 Weeks:
Gradual increase in shoulder movement
3 Months:
Begin strengthening exercises
4–6 Months:
Return to moderate activities
Office work: 3–4 weeks
Light household tasks: 8–10 weeks
Heavy lifting or strenuous activity: 16–24 weeks
Driving: Around 8 weeks, when you can safely control the vehicle
Total shoulder replacement is a highly successful surgery.
About 85% of patients experience excellent pain relief and functional improvement.
Approximately 10% feel better but continue to have some discomfort or stiffness.
Around 5% may feel no improvement or may worsen due to complications.
Longevity depends on activity level, implant type, and age at the time of surgery.
Anatomic replacements: About 90% last at least 10 years, and many last substantially longer.
Hemiarthroplasties: Often durable, but the natural socket may wear over time, especially in active individuals. Most require revision after around 8 years.
Like any major joint replacement, shoulder replacement carries some risks, although serious complications are uncommon.
Anaesthesia complications (1 in 1000) — Rare due to modern monitoring
Blood clots (1 in 500) — Prevented with stockings and medication
Infection (≈2%) — May require further surgery and antibiotics
Stiffness (≈10%) — Some motion limitations may persist
Instability (1–2%) — May require revision if recurrent
Persistent pain (5–10%)
Fracture during or after surgery (≈1%)
Nerve injury (≈1%) — Usually temporary but can be permanent
Your surgeon takes multiple precautions to minimise these risks, but they cannot be eliminated entirely.
A Reverse Total Shoulder Replacement is a specialised procedure used when the rotator cuff is severely torn, irreparable, or no longer functioning, leading to painful arthritis, weakness, and loss of movement. It is also commonly performed for complex shoulder fractures, especially in older adults.
This surgery is most successful in patients over 70 years, but it may also be the best option for younger individuals with complex shoulder problems.
In a normal shoulder, the rotator cuff balances and stabilises the joint, while the deltoid muscle lifts the arm.
When the rotator cuff fails:
The humeral head (ball) drifts upward
The joint mechanics collapse
Pain increases
Lifting the arm becomes very difficult
A reverse shoulder replacement changes the joint design:
The ball implant is fixed to the shoulder blade
The socket is placed on the arm bone
Moves the centre of rotation inward and downward
Tensions and lengthens the deltoid
Doubles the deltoid’s mechanical advantage
Stops the humeral head from migrating upward
This new geometry allows the deltoid muscle alone to raise the arm, even without a functioning rotator cuff.
Surgery is done under general anaesthesia with a nerve block for pain relief
Your hospital stay is typically 2–3 days
An incision is made at the front of the shoulder
Damaged cartilage and bone are removed
Specially engineered metal and polyethylene implants are placed
The ball is attached to the shoulder blade, and the socket is fixed to the upper arm bone
This creates a stable and smooth new joint.
You will wake up in a sling with temporary numbness due to the nerve block.
The next day, you will have:
A shoulder X-ray to check implant position
Routine blood tests
Blood-thinning injections for a day or two
A physiotherapy session to begin gentle movement
Most patients return home by Day 2.
Keep the dressing dry and intact for 2 weeks
Showering is allowed with precautions as advised
0–4/6 Weeks: Sling protection
6 Weeks: Begin active range-of-motion exercises
3 Months: Start strengthening
12 Months: Full functional recovery may continue to improve for a year or more
Desk work: 3–4 weeks
Daily household tasks: 8–12 weeks
Heavy lifting or strenuous activity: 16–24 weeks
Driving: Around 8 weeks, once comfortable and safe
Most patients experience dramatic pain relief and improved function.
85% are very satisfied
10% feel improved but still notice some limitations or discomfort
5% feel no improvement or worsen, usually due to complications
Current evidence shows:
90% of implants last 10 years or more
Newer implant designs may last even longer
However, because the deltoid muscle does the heavy work, some patients—especially younger, active individuals—may notice a gradual decline in strength or motion after 7–10 years due to deltoid fatigue.
Reverse shoulder replacement is major surgery, and although complications are uncommon, they can occur.
Anaesthetic complications (<1%)
Blood clots (1 in 500)
Infection (~2%)
Bleeding (transfusion needed in <10%)
Stiffness (≈10%) — Motion may never be fully normal
Persistent pain (5–10%)
Instability (1–2%) — May require revision
Fracture (1–2%) — During or after surgery
Implant loosening or failure to integrate (<5%)
Nerve injury (≈1%) — Usually temporary
Scapular notching — Wear at the edge of the shoulder blade; usually does not affect function
Your surgeon takes special measures to minimise these risks, but some cannot be fully prevented.
Most collarbone fractures heal without surgery, but when the break is significantly displaced, shortened, or unstable, your surgeon may recommend surgical fixation. This is typically done using a clavicle-specific plate and screws, and in certain lateral fractures a ligament augmentation may be added for extra stability.
The procedure is usually performed as a day-care surgery under general anaesthesia, often combined with a regional nerve block to reduce pain afterward.
A carefully planned incision is made along the collarbone.
For mid-shaft fractures, the cut is often angled for a better cosmetic result.
For fractures closer to the shoulder tip, the incision is placed on top of the bone (where a bra strap might sit in women).
Small skin nerves are located just beneath the collarbone. These are often divided during surgery, which creates a temporary or permanent numb patch below or lateral to the scar. This area usually shrinks with time and rarely causes significant discomfort.
The broken bone ends are realigned (reduced) and secured using a specially designed low-profile plate and screws.
If the fracture extends laterally and the bone fragments are too small, ligament reconstruction or suture-button augmentation may also be used for stability.
The wound is closed with dissolvable stitches and covered with a dressing.
Clavicle fixation is generally safe, but all surgical procedures carry some risk. You should be aware of the following:
Major blood vessels lie behind the collarbone. Injury to these is extremely uncommon but can lead to serious bleeding or air embolism. Rare case reports describe fatal events, but the overall risk is exceptionally low.
A numb area beneath or to the side of the scar is expected, as sensory nerves are cut during the incision.
Major nerve injury that affects arm strength is extremely rare but slightly more likely in revision or non-union surgeries.
The top of the lung sits just behind the clavicle. Accidental puncture can occur but is rare. If it happens, a chest tube may be needed temporarily.
Most infections are mild, but some may require antibiotics or additional surgery.
Very uncommon after plating, but if the bone does not heal properly, revision surgery may be required.
You will wake up wearing a sling and usually return home the same day.
Begin your pain medication before the nerve block wears off.
The shoulder typically feels much more comfortable once the bone is stabilised.
Keep the dressing in place until your 2-week follow-up, where your wound will be checked and an X-ray performed.
Gentle arm and shoulder movement can start immediately.
Avoid heavy lifting, pushing or pulling for at least 8 weeks.
Office work: ~2 weeks
Light manual work: 6–8 weeks
Heavy labour: 12–18 weeks
Driving: Allowed once you can confidently and safely control the vehicle — usually after a few weeks, depending on comfort and motion
A proximal humerus fracture is a break in the upper part of the arm bone, close to the shoulder joint. Depending on the fracture pattern, bone quality, and your age, the treatment may range from minimally invasive fixation to joint replacement.
Surgery is recommended when the fracture is displaced, unstable, involves multiple fragments, or is unlikely to heal well without intervention.
This is the standard treatment for many shoulder fractures.
A 10–12 cm incision is made at the front of the shoulder.
The broken bone fragments are realigned and secured using a specially designed proximal humerus locking plate fixed with screws.
This method provides strong, stable fixation and allows early gentle movements.
Used when a smaller portion of the bone—often the greater tuberosity—is pulled off by the rotator cuff tendons.
Performed through a small 5 cm incision on the side of the shoulder.
Strong suture anchors are used to secure the bone fragment back into place.
An alternative to plating for certain fracture types.
A 3 cm incision is made over the top or side of the shoulder.
A metal rod is inserted into the center of the bone, providing stable internal support.
Best suited for specific fracture patterns.
Recommended for:
Severely comminuted fractures
Very poor bone quality
Older patients (typically >65 years)
Irreparable damage to the humeral head or rotator cuff
A reverse shoulder replacement often provides more predictable results than a standard hemiarthroplasty in trauma cases.
Performed under general anaesthesia, often with an additional regional block for pain relief.
Most patients stay overnight.
You will wake up in a sling, and your arm may remain numb for several hours due to the nerve block.
Although complications are uncommon, this surgery can be complex. Important risks include:
Major bleeding is very rare. Some patients may require a small blood transfusion after surgery.
Several important nerves run close to the shoulder.
Injury is uncommon and usually caused by stretching, not cutting.
Most nerve injuries recover over time.
May require antibiotics or, occasionally, further surgery.
Up to 20% risk, especially in bones with poor blood supply or very weak bone quality.
Revision surgery may be required.
In shoulder replacements, proper healing of the tuberosities is crucial — it occurs reliably in ~80% of reverse replacements.
Occurs in ~10% of cases.
Blood supply issues from the original injury increase this risk.
If the fracture collapses around the screws, they may protrude into the joint and cause irritation.
Occurs in about 10% of cases.
May require removal of the hardware.
Start your pain medication before the nerve block wears off for better comfort.
Most patients go home 1 day after surgery.
Gentle shoulder movements begin very early under physiotherapist guidance.
Some movements will be restricted until healing is secure.
Keep dressings on until your 2-week clinic visit for wound check and X-ray.
Office Work: 3–4 weeks (while using a sling)
Light Manual Work: ~12 weeks
Heavy Manual Work: 18–26 weeks
Driving: 8–12 weeks (when safe and pain-free)
Full rehabilitation can take 12–18 months, depending on fracture severity, bone quality, and healing progress. Commitment to physiotherapy is crucial for regaining strength and motion.
A humeral shaft fracture is a break in the long, central portion of the upper arm bone. When the fracture is displaced, unstable, or unlikely to heal well on its own, surgery is recommended.
There are two main surgical options—plate fixation and nail fixation. Both methods offer excellent healing rates and allow patients to return to their normal activities with proper rehabilitation. Your surgeon will choose the best technique based on the fracture pattern, bone quality, your age, and activity level.
Plate fixation involves securing the broken bone with a metal plate and screws.
A longer incision is required—usually matching the length of the plate.
Midshaft and upper (proximal) fractures are approached from the front of the arm (anterior approach).
Lower shaft fractures may need an incision at the back of the arm (posterior approach).
The bone fragments are aligned and fixed firmly with the plate and screws.
This technique provides strong stability and is ideal for many fracture types.
This method uses a metal rod (nail) placed inside the center of the bone.
A small incision is made on the outer aspect of the shoulder.
Additional tiny incisions are used to insert locking screws.
The nail passes through the humeral head into the shaft, providing internal support.
This minimally invasive option is particularly useful for certain fracture patterns.
Although humeral shaft fixation generally has a low complication rate, certain risks exist:
Most infections are superficial, but a deep infection may require additional surgery and antibiotics.
The radial nerve runs very close to the humerus and may be stretched or trapped by the fracture itself.
During surgery, great care is taken to protect it.
Most nerve injuries involve stretching and recover over weeks or months.
Rarely, if the nerve is cut, it requires repair or grafting, and recovery becomes less predictable.
Some patients experience shoulder or elbow stiffness after either plating or nailing.
This typically improves with physiotherapy.
Only rarely is further surgery required.
If the bone fails to heal, revision surgery may be needed.
Risk is higher in smokers, diabetics, and patients with severe fractures.
If you are undergoing surgery for a previously unhealed fracture (non-union) or revision of earlier fixation, the complication risk is slightly higher than in first-time (primary) surgery.
With 9+ years of experience, Dr. Yogesh Jain provides expert care in sports injuries, arthroscopy, and trauma.
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