Shoulder Surgery

Indication: Symptomatic full-thickness tears causing pain and weakness.

Technique: Minimally invasive keyhole repair using bio-composite suture anchors to secure torn tendons back to the humeral footprint.

Indication: High-grade articular or bursal-sided tears failing conservative rehabilitation.

Technique: Tear completion and repair or in-situ trans-tendinous repair preserving intact tendon fibres.

Indication: Small to moderate mobile tendon tears with good tissue quality.

Technique: Single line of suture anchors providing anatomical footprint compression.

Indication: Broad-based crescent or U-shaped tears requiring maximum footprint contact area.

Technique: Medial and lateral row anchor configuration creating a compressive suture bridge for superior biomechanical strength.

Indication: Retracted multi-tendon tears (>5 cm) involving supraspinatus and infraspinatus.

Technique: Interval slides, partial repair, margin convergence, and biologic patch augmentation to restore shoulder force couples.

Indication: Re-tears following previous surgery with recurrent weakness or pain.

Technique: Removal of failed implants, extensive adhesiolysis, medialized footprint fixation, and graft reinforcement.

Indication: Younger active patients with irreparable rotator cuff tears and no severe arthritis.

Technique: Fascia lata or dermal allograft reconstruction spanning glenoid to greater tuberosity to stabilize the humeral head.

Indication: Chronic irreparable posterosuperior or anterosuperior tears in younger individuals.

Technique: Latissimus dorsi, lower trapezius, or pectoralis major transfer to restore active external rotation or elevation.

Indication: Refractory impingement syndrome caused by hooked acromial bone spurs.

Technique: Arthroscopic burr resection of subacromial spurs and release of the coracoacromial ligament.

Indication: Anterior shoulder dislocation with labral detachment and minimal glenoid bone loss (<15%).

Technique: Keyhole mobilization of the labrum and re-anchoring to the anterior glenoid rim using suture anchors.

Indication: Posterior shoulder instability common in contact athletes, bench pressers, or seizure patients.

Technique: Arthroscopic capsulolabral plication and suture anchor fixation of the posteroinferior glenoid rim.

Indication: Superior labrum anterior-to-posterior tears (Type II SLAP) in throwing athletes.

Technique: Keyhole reattachment of the superior labrum and long head of biceps anchor to the top of the glenoid.

Indication: Engaging Hill-Sachs humeral head defects co-existing with anterior instability.

Technique: Arthroscopic infraspinatus and posterior capsule tenodesis directly into the humeral head defect.

Indication: Recurrent instability with critical glenoid bone loss (>15-20%), failed prior Bankart, or high-risk collision athletes.

Technique: Coracoid process osteotomy and transfer through the subscapularis onto the anterior glenoid rim with screw fixation (the 'triple blocking effect').

Indication: Significant bone loss where coracoid bone is unsuitable or revision Latarjet is needed.

Technique: Autologous iliac crest or distal tibial allograft fixation to reconstruct the anterior glenoid articular arc.

Indication: Recurrent dislocation after previous Bankart or failed open stabilisation.

Technique: Careful workup of bone defects, capsular stretching, and revised fixation with bone grafting or capsular reconstruction.

Indication: Generalized joint laxity with multidirectional symptomatic subluxations failing physical therapy.

Technique: Arthroscopic circumferential capsular plication and rotator interval closure to balance joint volume.

Indication: Biceps tendinopathy, subluxation, partial tearing, or SLAP tears in patients over 35.

Technique: Release of long head of biceps from the superior labrum and secure anchor fixation within the bicipital groove.

Indication: Persistent groove tenosynovitis or revision biceps pathology.

Technique: Mini-open subpectoral or suprapectoral fixation with interference screw or cortical button.

Indication: Proximal biceps pathology requiring anatomical tensioning at the top of the groove.

Technique: Arthroscopic or mini-open anchor fixation above the pectoralis major insertion.

Indication: Extensive tenosynovitis involving the entire length of the intertubercular groove.

Technique: Mini-open fixation below the groove to eliminate all intra-articular and groove pain generators.

Indication: Older or low-demand patients with painful biceps tendinopathy or complex rotator cuff tears.

Technique: Simple arthroscopic release of the tendon, offering rapid pain relief and early active mobilization.

Indication: Concomitant supraspinatus/subscapularis tears with unstable or degenerative biceps tendon.

Technique: Simultaneous keyhole tenodesis and cuff anchor repair through shared portals.

Indication: Degenerative fraying of the labrum without true mechanical instability.

Technique: Arthroscopic smoothing of irregular labral edges using radiofrequency probes.

Indication: Refractory frozen shoulder (adhesive capsulitis) failing conservative treatment for 6+ months.

Technique: 360-degree targeted release of the thickened, contracted shoulder capsule and coracohumeral ligament.

Indication: Post-traumatic or post-surgical scar tissue restricting range of motion.

Technique: Keyhole excision of subacromial and subdeltoid fibrous adhesions to restore gliding planes.

Indication: Mild to moderate shoulder osteoarthritis with persistent mechanical catching.

Technique: Lavage of inflammatory enzymes, smoothing of unstable cartilage flaps, and marginal osteophyte debridement.

Indication: Synovial chondromatosis, cartilage chips, or fractured osteophytes causing locking.

Technique: Arthroscopic retrieval of floating loose fragments under direct high-definition visualization.

Indication: Focal full-thickness cartilage defects on the humeral head or glenoid.

Technique: Microfracture, biologic chondroplasty, or restorative regenerative matrix techniques.

Indication: Painful AC joint arthritis or osteolysis that radiates to the top of the shoulder and neck.

Technique: Resection of the distal 5-8 mm of the clavicle (Mumford procedure) via keyhole subacromial approach.

Indication: End-stage glenohumeral osteoarthritis with intact, healthy rotator cuff tendons.

Technique: Resurfacing the humeral head with a metal stem/head and cementing a polyethylene glenoid socket.

Indication: Cuff tear arthropathy (severe arthritis combined with massive irreparable rotator cuff tear) or complex fractures.

Technique: Reversing natural anatomy: placing a prosthetic ball (glenosphere) on the socket and a cup on the humerus to recruit the deltoid muscle as prime mover.

Indication: Isolated humeral head osteonecrosis (avascular necrosis) or severe proximal humerus fractures with normal glenoid.

Technique: Replacing only the humeral head while preserving the native glenoid cartilage.

Indication: Loosening, dislocation, periprosthetic infection, or cuff failure following previous replacement.

Technique: Complex implant removal, bone graft reconstruction, and conversion to reverse shoulder geometry.

Indication: Displaced 3-part or 4-part fractures of the upper arm bone.

Technique: Anatomical reduction and locking plate fixation (PHILOS plate) or primary reverse replacement for head-split osteoporotic fractures.