Comprehensive Solutions for Complex Shoulder Conditions with Dr. Matthew DiPaola
While many shoulder conditions can be treated arthroscopically (through small incisions using a camera), certain injuries and disorders require a more traditional open surgical approach. Open shoulder surgery allows for direct access to deeper or more complex anatomical structures, making it the preferred choice for specific cases such as advanced arthritis, large rotator cuff tears, or fractures.
As a fellowship-trained shoulder and elbow specialist, Dr. Matthew DiPaola performs a full range of open shoulder procedures—from joint replacement to complex tendon transfers—with precision, compassion, and a personalized approach to care.
Explore the most common open shoulder surgeries offered in Dr. DiPaola’s practice:
Shoulder Replacement Surgery
Total Shoulder Replacement
Recommended for patients with advanced arthritis and a functioning rotator cuff. The damaged surfaces of the ball-and-socket joint are replaced with smooth metal and plastic components to restore motion and reduce pain.
Reverse Shoulder Replacement
Used when the rotator cuff is severely torn or nonfunctional. This design “reverses” the ball and socket to shift the mechanics of the shoulder, allowing the deltoid muscle to take over for the damaged rotator cuff.
Revision Shoulder Replacement
Performed when a previous shoulder replacement has failed due to loosening, infection, or wear. Revision surgery can restore stability and function with updated implants and surgical techniques.
Partial Shoulder Replacement (Hemiarthroplasty)
In this procedure, only the ball portion of the shoulder joint is replaced. It may be appropriate in cases of fracture or arthritis where the socket (glenoid) is still healthy.
AC Joint Reconstruction and Repair
For patients with significant acromioclavicular (AC) joint injury or arthritis, this procedure stabilizes the joint where the collarbone meets the shoulder blade. It’s often needed in active individuals or those with chronic shoulder pain from joint degeneration.
Fracture Repair
Clavicle, Humerus, and Scapula Fractures
When fractures are displaced, unstable, or don’t heal with conservative treatment, surgical repair may be needed. Open surgery allows for the use of plates, screws, or rods to realign the bone and promote healing.
Rotator Cuff Repair (Open and Revision)
Open Rotator Cuff Repair
In some cases—especially very large or complex tears—an open approach may be more effective than arthroscopy. It allows Dr. DiPaola to directly visualize the tear and provide robust repair.
Revision Rotator Cuff Repair
If a prior surgery didn’t heal properly or the tendon retears, revision surgery may involve additional anchors or soft tissue grafts to reinforce the repair.
Open Rotator Cuff Repair with Soft Tissue Grafting
When rotator cuff tissue is poor or insufficient, biologic or synthetic grafts can be used to help reinforce the repair and improve outcomes.
Tendon Transfer Surgery
Latissimus Dorsi and Pectoralis Major Transfers
For irreparable rotator cuff tears, tendon transfer surgery allows another muscle—such as the latissimus dorsi or pectoralis major—to be redirected to compensate for lost function. These highly technical procedures can restore overhead movement and improve strength in carefully selected patients.
Surgery for Scapular Problems
Snapping Scapula Syndrome
A condition where abnormal contact between the scapula and ribcage causes painful snapping or grinding. Surgery may involve removing inflamed tissue or reshaping bone.
Scapulothoracic Fusion
Used in rare, severe cases when scapular movement causes debilitating pain and all other treatments have failed. The scapula is fused to the ribcage to eliminate motion.
Surgery for Winging Scapula
When the shoulder blade protrudes abnormally due to nerve or muscle injury, surgical stabilization may be performed to restore function and relieve discomfort.
Instability and Bone Loss Repair
Shoulder Instability Surgery
In cases of chronic dislocation or severe instability, open stabilization procedures repair torn ligaments and reconstruct the anatomy to prevent future dislocations.
Bone Loss Reconstruction
Significant bone loss from repeated dislocations or trauma may require grafting procedures or advanced techniques to restore the socket and provide lasting stability.
Other Open Shoulder Procedures
Shoulder Fusion
When motion causes constant pain and other treatments have failed, shoulder fusion may be used to stabilize the joint and eliminate discomfort by permanently fusing the bones.
Biceps Tenodesis
In cases of biceps tendon degeneration or pain, this procedure removes the damaged portion of the tendon and reattaches it to the upper arm to relieve symptoms and preserve strength.
Pectoralis Major Repair
A torn pectoralis major muscle (often injured in athletes or weightlifters) can be repaired surgically through an open approach to restore strength and function in the chest and upper arm.
When Is Open Surgery the Best Option?
Open surgery may be the preferred—or only—option when:
- The tear or fracture is too large or complex for arthroscopy
- Joint replacement is needed
- Significant bone or tendon damage has occurred
- A prior surgery failed and requires revision
Dr. DiPaola takes the time to evaluate each patient’s condition thoroughly. He works closely with you to determine whether open surgery, arthroscopy, or a non-surgical approach is best suited to your needs, lifestyle, and goals.
Considering Shoulder Surgery?
Schedule a consultation with Dr. DiPaola in New York to learn more about your options. If you need a joint replacement, rotator cuff repair, or fracture stabilization, you can trust you’re in expert hands.
Call 716-204-3200 or Schedule a consultation with Dr. DiPaola to explore open shoulder surgical options
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