Treatments &

Your shoulder is composed of three bones: your upper arm bone (humerus), your shoulder blade (scapula) and your collarbone (clavicle). The head of your upper arm bone fits into a rounded socket in your shoulder blade. A variety of muscles and tendons (rotator cuff) keep your arm bone centered in the socket. They cover the head of your upper arm bone and attach it to your shoulder blade. Most shoulder problems fall into four major categories: tendon inflammation or tendon tear, instability, arthritis, or fracture.

Diagnostic Shoulder Arthroscopy

Arthroscopic surgery allows diagnosis and treatment of joint problems through small incisions in the skin. A camera attached to a scope is used to see inside your joint.

What is diagnostic shoulder arthroscopy?
Arthroscopic shoulder surgery is a way for surgeons to see inside the joint to assist them with diagnosis.

What happens during a diagnostic shoulder arthroscopy procedure?
Through a small incision in the back of the shoulder, saline solution is flushed into the joint to expand it, providing your surgeon a better view. The arthroscope sends an image to a video monitor so your surgeon can see inside the joint. In some cases, the surgeon can repair the damage he or she sees inside the joint through the same procedure.

Fully Torn Rotator Cuff

What is a torn rotator cuff?
A torn rotator cuff occurs when one or more of the tendons of the rotator cuff tears, sometimes detaching completely from the bone. Rotator cuff tears can be caused by accumulated damage from repetitive motions or by sudden injury. 

What is a total rotator cuff tear?
A fully torn rotator cuff tendon is detached from the humerus.

What happens during a total rotator cuff repair surgery?
There are a few different surgical approaches to fully torn rotator cuffs. The technique your surgeon selects depends on the severity of the tear, the status of your tissues, and your specific anatomy.

Open Repair
Open shoulder surgery for a torn rotator cuff may be required for severe cases of injury or degeneration. Open surgery for rotator cuff injuries involves grafting tissues from another part of your body to replace damaged tissue.

Mini Open Repair
Mini-open repair surgery for a torn rotator cuff involves a small incision that is larger than the one made in arthroscopic repair, but not as large as what is required for open repair. You may be a candidate for mini-open repair if you have moderate tissue damage in your rotator cuff that cannot be removed or repaired through arthroscopic surgery.

Arthroscopic Repair
An arthroscopic repair surgery for a fully torn rotator cuff is typically done under general anesthesia and/or a nerve block. Small incisions are made at the front and the back of your shoulder. The joint is flushed with saline solution to wash away any debris from the tear and to expand the joint. This expansion makes room for a tiny camera called an arthroscope that allows the surgeon to see inside the shoulder joint.

Bone spurs in the area are removed, as well as any severely damaged tendon tissue. Suture anchors are placed in the head of the humerus to reattach the torn tendon to the bone.

Patients typically return home from arthroscopic repair of a fully torn rotator cuff the same day as the procedure. Recovery involves medication and physical therapy. Complete recovery for a fully torn rotator cuff repaired through arthroscopy can take up to 6 months.

Partially Torn Rotator Cuff Repair

What is a partial rotator cuff tear?
A partially torn rotator cuff occurs when a tendon of the rotator cuff tears, but does not detach from bone.

What happens during a partial rotator cuff repair surgery?
In a partial rotator cuff repair, part of the acromion bone is removed to make more room for the rotator cuff.  Small incisions are made at the back and side of the shoulder. Saline solution flows into the bursa sac to expand the joint. This expansion makes room for a tiny camera called an arthroscope that allows the surgeon to see inside the shoulder joint.

The inflamed bursa sac is removed. In some cases, a ligament in the area is also removed.  Any frayed edges on the torn rotator cuff are smoothed down.

Total Shoulder Replacement

Total shoulder replacement is performed when arthritis or degenerative joint disease make the shoulder stiff and painful. The procedure replaces the bone surfaces of the shoulder joint with a metal humeral head (ball) in the upper arm (humerus) and a specially reinforced polyethylene plastic socket (glenoid).

What is a total shoulder replacement?
Arthritis and other degenerative conditions can cause pain, stiffness, and weakness when the cartilage lining the shoulder joint wears down. In a total shoulder replacement surgery, the ball and socket of the shoulder joint are replaced with synthetic materials to encourage smooth, gliding movement.

What happens during total shoulder replacement surgery?
An incision is made in the front or the side of the shoulder. Muscles and tendons are moved aside to provide your surgeon access to the joint. The head—which is the “ball” in the “ball-and-socket” joint—is removed from your humerus, or upper arm bone. The glenoid, or socket, is cleaned out, and a cup made of a synthetic material is cemented in. A stem is inserted into the humerus, and a new head is attached to the stem.

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