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Outpatient Minimally Invasive Total Shoulder Replacement

Minimally invasive total shoulder replacement (MIS TSR) is a new procedure that enables a total shoulder replacement with ‘metal and plastic’ parts to be performed as an outpatient procedure through a smaller incision and does not involved moving/cutting any of the rotator cuff muscles about the shoulder. This procedure was defined first by Laurent Lafosse, a renowned shoulder surgeon in France with whom I trained, and first described in an article that I wrote with Laurent in 2009 (see article link below).

I have continued working here in the United States with a team of surgeons and engineers to perfect this technique that I believe has several potential advantages. First, MIS TSR enables me to perform a replacement without cutting any of the rotator cuff muscles about the shoulder–something that is routinely done with conventional total shoulder replacement. Not cutting the rotator cuff theoretically enables the patient/surgeon to avoid any of the potential complications associated with rotator cuff problems after total shoulder replacement surgery.

In addition, there are no activity restrictions after MIS TSR since there is no need to ‘protect’ a rotator cuff repair (a routine part of conventional total shoulder replacement). Second, MIS TSR enables a smaller incision and enters the joint be traveling ‘between’ the rotator cuff muscles so it is less invasive and reasonable to perform as an outpatient procedure. To read more about this procedure see the attachment below.


Primary total shoulder arthroplasty performed entirely thru the rotator interval: Technique and minimum two-year outcomes