Shoulder surgery may be appropriate if you’ve had pain or problems with your shoulder that are not fully solved by less-invasive treatment methods such as physical therapy, ice and rest, and/or medications. Some of the top reasons for surgery are tendonitis, bursitis, or a rotator cuff concern. If a doctor recommends surgery as the best solution for your situation, there are different types of shoulder surgery that might be used depending on your situation.
Arthroscopy vs Open Surgery
The two main types of shoulder surgery are arthroscopy and open surgery. The American Academy of Orthopaedic Surgeons explains that arthroscopy gives an outpatient option that uses small incisions into which the surgeon inserts a thin device with a light and lens. The doctor can see inside the joint on a monitor while performing repairs to the shoulder, which potentially involves using additional instruments within the incisions. The second type, open surgery, involves small incisions that are about a few inches each. The best type will vary by your physician and the specifics of your shoulder injury or damage.
Variations of Shoulder Surgery
The many types of shoulder surgery are simply variations of arthroscopic procedures and open surgery based on the type of injury or part of the shoulder being addressed. While the following is not a complete list of all the types in existence, it includes some of the main ones:
Impingement Syndrome Arthroscopy
Arthroscopy surgery may be performed for impingement syndrome, which refers to the rotator cuff tendons being periodically pressed when the shoulder is moved. In time, this pattern causes damage to the shoulder tendons and joint cushions known as a bursa. An orthopedic surgeon may use subacromial decompression, which is a type of arthroscopy that creates more space between the shoulder’s acromion at the top and the rotator cuff.
Rotator Cuff Repair
When the rotator cuff is damaged, a surgeon can use surgery to clean, reattach, and restore tendons in the area. This type of repair can be performed by open surgery or arthroscopy surgery, depending on the surgeon’s preference and the nature of each patient’s case. For example, orthopedic surgeon Dr. Jonathan Cluett explains for Verywell Health that an open rotator cuff repair is the traditional method that uses a long incision, while arthroscopy may be used on smaller rotator cuff injuries. He also notes that a mini-open rotator cuff repair provides anchors to attach tendons to the shoulder bone when the damage is particularly severe.
In some cases, there is instability in the shoulder. For example, multidirectional instability causes the joint to move in and out of the shoulder socket, or AC joint instability creates ligament damage that can result in shoulder separation that can become severe enough to need surgery instead of other interventions. A surgeon may use different types of surgery for instability, such as Bankart repair that holds the shoulder’s ball in its proper place by connecting the labrum to the joint capsule. Your surgeon may explain that an arthroscopy is an option for instability in the shoulder.
One common type of shoulder surgery is a superior labrum anterior and posterior (SLAP) tear. While it has a complex name, it simply refers to an injury to the cartilage in the front and back of the shoulder’s socket, called the labrum. An orthopedic surgeon can use arthroscopy surgery to reposition the cartilage.
In severe cases, it may be necessary to replace the shoulder joint’s bones with artificial ones through surgery. Medline Plus explains that a partial shoulder replacement would replace either the ball or the socket, while a total shoulder replacement would provide artificial versions of both parts. This surgery was traditionally an inpatient open surgery but technology has made arthroscopy outpatient versions possible.
This list provides just some of the many shoulder surgery options available. Orthopedic surgeons are able to work on different parts of the shoulder through different techniques to provide solutions to a range of shoulder problems.
Shoulder Surgery for Your Individual Case
While there are many types of shoulder surgery, an orthopedic surgeon can determine the best one for your situation. In general, the doctor would choose between two types of surgery: arthroscopy or open surgery. Then, the variations depend on the type of injury or damage you’re experiencing in your shoulder. In most cases, a physician would have you start with non-invasive interventions and then move on to shoulder surgery if those solutions did not fully treat the problem.