Types of shoulder surgery: what each procedure fixes and how long recovery takes

This guide is for people who have been told they may need shoulder surgery and want to understand the options before meeting a surgeon. It covers the difference between arthroscopic and open surgery, who each procedure is for, and the typical recovery for each. The ranges come from the American Academy of Orthopaedic Surgeons, NHS hospital leaflets, Canadian health guides and published studies; your surgeon’s protocol sets your own.

Arthroscopic vs open shoulder surgery: what is the difference?

In arthroscopic surgery, the surgeon inserts a small camera into the joint through very small incisions and works with thin instruments while watching a monitor. The AAOS lists rotator cuff repair, removal or repair of the labrum, ligament repair, removal of inflamed tissue or loose cartilage, and repair for recurrent dislocation among the common arthroscopic procedures. Most take less than 2 hours, patients go home the same day, and the AAOS describes less pain and a faster return to activity than open surgery.

Open surgery uses a longer incision and direct view. The AAOS notes that shoulder replacement still requires open surgery, and that open rotator cuff repair is reserved for large or complex tears or cases that need added reconstruction such as a tendon transfer. For the cuff, the AAOS surgical options page says most tears are now repaired arthroscopically, that all three techniques (open, mini-open and arthroscopic) give similar pain relief, function and satisfaction, and that the surgeon’s expertise matters more than the choice of technique.

Rotator cuff repair

What it treats. A torn rotator cuff tendon, usually the supraspinatus. The AAOS lists the reasons a surgeon recommends repair: pain that persists after nonsurgical treatment, symptoms lasting 6 to 12 months, a tear larger than 3 cm with good tissue quality, significant weakness, or a recent acute injury.

How it is done. The surgeon reattaches the tendon to the upper arm bone with suture anchors through small portals, as same-day surgery. Pathway’s surgeons perform arthroscopic rotator cuff repair with knotless anchors and, for some tears, a collagen implant placed over the repair.

Recovery. The AAOS describes a sling and rest for the first 4 to 6 weeks, therapist-assisted passive motion in that window, active motion after 4 to 6 weeks, strengthening from 8 to 12 weeks, and functional motion with adequate strength by 4 to 6 months. A meta-analysis of 859 patients found 84.7% returned to sport after repair, 65.9% at the same level, after 4 to 17 months; recreational athletes fared better than competitive ones. Pathway’s guide to rotator cuff surgery recovery walks through each phase.

Labral and Bankart repair

What it treats. Shoulder instability. When the shoulder dislocates forward, it often tears the labrum and ligaments off the front rim of the socket, a Bankart lesion. The AAOS says instability is usually treated first with activity changes, anti-inflammatories and physiotherapy, and that surgery is offered to people with repeated dislocations or with bone loss on imaging.

How it is done. The surgeon uses sutures and anchors to reattach the labrum and ligaments to the bone, almost always arthroscopically as a same-day procedure. When a dent in the ball of the joint adds to the instability, surgeons may add a remplissage, which fills that dent with the back of the cuff. A 2023 meta-analysis of 538 athletes found 86% returned to sport after Bankart repair with remplissage, with a 5% recurrence rate in athletes.

Recovery. The Sherwood Forest Hospitals NHS Bankart repair leaflet describes a sling for about four weeks, no driving for at least four weeks, light work from 4 to 6 weeks, heavy overhead work from 3 to 6 months, breaststroke and jogging from 6 to 10 weeks, weight training and freestyle at 3 months, and full contact sport at around 6 months. Pathway’s Bankart labral repair page gives a similar plan: sling 4 to 6 weeks, motion to 12 weeks, strengthening at months 3 to 4, and sport at 4 to 6 months with surgeon clearance.

Latarjet procedure

What it treats. Instability with bone loss. Repeated dislocations can wear away the front of the socket, and a soft-tissue repair alone then has less to hold. Pathway’s Latarjet page lists glenoid bone loss greater than 20%, a failed prior Bankart repair, contact or collision athletes, and multiple dislocations as the usual reasons.

How it is done. The surgeon moves a piece of the coracoid bone from the shoulder blade, with its attached tendon, to the front of the socket and fixes it with screws. The bone widens the socket and the attached tendon helps hold the shoulder in place when the arm is raised or rotated. The Sherwood Forest Bristow-Latarjet leaflet describes it as an open operation through an incision of about 7 cm, done as same-day surgery.

Trade-offs. A meta-analysis of 3,275 shoulders found arthroscopic Bankart repair carried about 2.9 times the risk of recurrence and 2.7 times the risk of redislocation compared with Latarjet, with the gap widest 6 to 10 years after surgery, while Bankart repair carried a lower risk of infection. A review of 1,036 patients found similar return to the same level of sport after arthroscopic Bankart repair (71%) and Latarjet (73%), with recurrent dislocation in 3.5% after Latarjet and 6.6% after Bankart repair.

Recovery. The NHS leaflet describes a sling for two to six weeks, no driving for at least four weeks, light work from 4 to 6 weeks, heavy work from 3 to 6 months, and full contact sport at around six months. Pathway’s page places strengthening at months 3 to 4 and return to sport at 5 to 6 months with surgeon clearance.

Biceps tenodesis

What it treats. Pain from the long head of the biceps tendon where it passes through the shoulder: tendinitis that has stopped responding to treatment, partial tears of the tendon, and some SLAP tears of the upper labrum. The Royal Orthopaedic Hospital in the UK notes that biceps problems often occur alongside a rotator cuff tear, so the two are frequently repaired in the same operation.

How it is done. The surgeon releases the damaged tendon from inside the joint arthroscopically and reattaches it to the upper arm bone through a small incision, with an anchor. The alternative, tenotomy, releases the tendon without reattaching it. A meta-analysis of five randomized trials found the two give similar pain, function and strength, but tenotomy left a visible “Popeye” bulge in 23.3% of patients compared with 6.8% after tenodesis. Pathway’s surgeons perform biceps tenodesis with knotless anchors.

Recovery. This is usually the quickest shoulder repair. Pathway’s page describes a sling for 2 to 4 weeks, range of motion restored by 4 to 8 weeks, biceps strengthening from 8 to 12 weeks, and normal use of the arm at 3 to 4 months. The Royal Orthopaedic Hospital describes significant improvement at about 4 to 6 months, with gains continuing to 12 months.

Anatomic and reverse shoulder replacement

What it treats. Arthritis and joints that can no longer be repaired. The AAOS describes an anatomic total replacement, a metal ball and plastic socket, for bone-on-bone arthritis with an intact rotator cuff. A reverse replacement swaps the ball and socket so the deltoid muscle can lift the arm; it is used for irreparable cuff tears, cuff tear arthropathy, failed prior replacements and complex fractures. A 2025 meta-analysis of 14 studies found surgeons increasingly use the reverse design even when the cuff is intact, with fewer complications and reoperations but less external rotation than an anatomic replacement.

How it is done. Open surgery, usually about 2 hours, with discharge the same day or after one night. Pathway’s surgeons perform anatomic and reverse replacement with a system that offers both options.

Recovery. The AAOS describes a sling for about 2 to 6 weeks, simple tasks such as eating and dressing within about 2 weeks, no driving for about 2 to 6 weeks, no lifting heavier than a glass of water early on, and avoidance of contact sports and repetitive heavy lifting for the life of the implant. Alberta Health Services says full recovery takes at least 6 months, and the Royal Berkshire NHS leaflet lists golf from 3 months and strength gains continuing up to 18 months.

How the procedures compare

The ranges combine the AAOS, Sherwood Forest Hospitals and Royal Berkshire NHS leaflets, Alberta Health Services and Pathway’s procedure pages, as cited above. Your surgeon adjusts them to the size of the repair, the quality of your tissue and the demands of your work and sport.

How surgeons choose the procedure

• What is damaged. A torn tendon gets a repair; a torn labrum gets a labral repair; a worn joint gets a replacement.
• Bone loss. Imaging that shows a worn socket rim or a dent in the ball moves an instability repair from Bankart alone toward remplissage or Latarjet.
• The state of the rotator cuff. It decides between an anatomic and a reverse replacement, and it decides whether a massive tear is repairable at all.
• Tissue quality and age. The AAOS lists poor tendon quality, large tears, age over 65 and smoking among the factors that lower the chance of a satisfactory cuff repair.
• Your sport and your job. Contact athletes and overhead workers push surgeons toward the more durable option, even when it means a longer recovery.
• What has already been tried. A failed Bankart repair is a common reason for Latarjet; a failed replacement is a reason for a reverse.

Quick answers

Is most shoulder surgery arthroscopic?

Most soft-tissue repairs are. The American Academy of Orthopaedic Surgeons says most rotator cuff tears are now repaired arthroscopically, and labral repair and repairs for recurrent dislocation are usually arthroscopic as well, while biceps tenodesis combines an arthroscopic release with a small incision. Shoulder replacement and the Latarjet bone-block procedure are open operations.

How long does shoulder surgery take?

Most arthroscopic procedures take less than 2 hours, and a shoulder replacement usually takes about 2 hours. Almost all of these procedures are same-day surgery; a replacement is sometimes followed by one night in hospital.

Which shoulder surgery has the longest recovery?

Shoulder replacement and rotator cuff repair take the longest. The AAOS describes functional motion and adequate strength at 4 to 6 months after rotator cuff repair, and Alberta Health Services describes full recovery from shoulder replacement as taking at least 6 months, with gains continuing up to 18 months. Biceps tenodesis is usually the quickest, with normal arm use at about 3 to 4 months.

Bankart repair or Latarjet: which is better for a dislocating shoulder?

It depends on bone loss. Arthroscopic Bankart repair reattaches the torn labrum and ligaments and suits shoulders with little bone loss. Latarjet moves a block of bone to rebuild the socket and is used for significant glenoid bone loss, failed Bankart repair and some contact athletes. A meta-analysis of 3,275 shoulders found Bankart repair carried about 2.9 times the risk of recurrence but a lower risk of infection.

Do I need surgery after a shoulder dislocation?

Often no. The AAOS says chronic shoulder instability is usually treated first with activity changes, anti-inflammatories and physiotherapy, and that it can take several months to judge how well that works. Surgery is offered to people with repeated dislocations, or when imaging shows bone loss on the socket or the ball.

Questions to ask your surgeon

• Which structures are damaged on my imaging, and which procedure addresses each one?
• Will the surgery be arthroscopic or open, and why?
• Do I have bone loss, and does that change the recommended procedure?
• How long will I wear a sling, and when does strengthening start?
• Given my job and my sport, when is a realistic return to each?
• What is the chance the repair fails or the shoulder dislocates again, and what would the next step be?
• If you are combining procedures, for example a cuff repair with a biceps tenodesis, how does that change recovery?

Pathway’s guide to shoulder surgery wait times in Canada covers what to expect from a public referral, and the shoulder and elbow procedures page lists every procedure Pathway’s surgeons perform. You can also read about Pathway shoulder surgeons Dr. Bashar Alolabi, Dr. Jason Smith and Dr. Jihad Abouali.

References

1. American Academy of Orthopaedic Surgeons (OrthoInfo). Shoulder Arthroscopy. Accessed October 21, 2026.
2. American Academy of Orthopaedic Surgeons (OrthoInfo). Rotator Cuff Tears: Surgical Treatment Options. Accessed October 21, 2026.
3. American Academy of Orthopaedic Surgeons (OrthoInfo). Chronic Shoulder Instability. Accessed October 21, 2026.
4. American Academy of Orthopaedic Surgeons (OrthoInfo). Shoulder Joint Replacement and Reverse Total Shoulder Replacement. Accessed October 21, 2026.
5. Sherwood Forest Hospitals NHS Foundation Trust. Arthroscopic Bankart repair (patient leaflet, revised May 2025). Accessed October 21, 2026.
6. Sherwood Forest Hospitals NHS Foundation Trust. Bristow-Latarjet operation (patient leaflet, revised February 2024). Accessed October 21, 2026.
7. The Royal Orthopaedic Hospital NHS Foundation Trust. Biceps Tenodesis. Accessed October 21, 2026.
8. Royal Berkshire NHS Foundation Trust, Orthopaedic Physiotherapy Department. Total shoulder replacement: discharge advice (August 2024). Accessed October 21, 2026.
9. Alberta Health Services. Shoulder Replacement Surgery: What to Expect at Home. MyHealth.Alberta.ca; current as of July 31, 2024. Accessed October 21, 2026.
10. Klouche S, Lefevre N, Herman S, et al. Return to sport after rotator cuff tear repair: a systematic review and meta-analysis. Am J Sports Med. 2016;44(7):1877–1887.
11. Imam MA, Shehata MSA, Martin A, et al. Bankart repair versus Latarjet procedure for recurrent anterior shoulder instability: a systematic review and meta-analysis of 3275 shoulders. Am J Sports Med. 2021;49(7):1945–1953.
12. Ialenti MN, Mulvihill JD, Feinstein M, et al. Return to play following shoulder stabilization: a systematic review and meta-analysis. Orthop J Sports Med. 2017;5(9):2325967117726055.
13. Davis WH, DiPasquale JA, Patel RK, et al. Arthroscopic remplissage combined with Bankart repair results in a higher rate of return to sport in athletes compared with Bankart repair alone or the Latarjet procedure: a systematic review and meta-analysis. Am J Sports Med. 2023;51(12):3304–3312.
14. Belk JW, Kraeutler MJ, Houck DA, et al. Biceps tenodesis versus tenotomy: a systematic review and meta-analysis of level I randomized controlled trials. J Shoulder Elbow Surg. 2021;30(5):951–960.
15. Daher M, Boufadel P, Fares MY, et al. Reverse versus anatomic total shoulder arthroplasty for glenohumeral osteoarthritis with intact cuff: a meta-analysis of clinical outcomes. J Shoulder Elbow Surg. 2025;34(1):190–202.

Health information notice: This article provides general information about shoulder procedures and typical recovery ranges and cannot replace individual medical advice. Your surgeon and care team choose your procedure and set your recovery plan based on your exam, your imaging, and your goals.