Arthroscopic Biological Total Shoulder Resurfacing

Arthroscopic Biological Total Shoulder Resurfacing — answers to common questions.

What is arthroscopic biologic total shoulder resurfacing?

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ABTSR is a minimally invasive surgery that uses arthroscopic instruments and a size-matched osteochondral allograft (donor tissue) to resurface a worn shoulder joint, instead of replacing the joint with a metal-and-plastic implant.

Who is a candidate for ABTSR?

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Ideal candidates are physically active patients — often under 50 — with advanced shoulder arthritis but reasonable remaining shoulder motion. Active older patients who want to preserve bone and avoid conventional shoulder replacement can also be candidates after a focused exam and imaging review.

How is ABTSR different from a traditional shoulder replacement?

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Traditional shoulder replacement removes and replaces the joint surfaces with metal and plastic. ABTSR preserves the bone and uses a biological graft, performed through arthroscopic incisions about one-third of an inch wide. The result is less tissue disruption, faster recovery, and easier revision if surgery is needed years later.

Is the rotator cuff cut during ABTSR?

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No. Because the procedure is performed arthroscopically, Dr. Kovack works around the rotator cuff rather than detaching it. That preserves shoulder mechanics and shortens recovery.

How long is recovery after ABTSR?

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Physical therapy starts the day after surgery. Most patients are out of a sling within 3–4 weeks, return to light daily activity within 6–8 weeks, and regain full strength and overhead activity at 3–6 months.

Is ABTSR covered by insurance?

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ABTSR is covered by most major insurance plans when medically indicated. Our team verifies coverage prior to scheduling and explains any out-of-pocket cost in advance.

Can I still have a conventional shoulder replacement later if I need one?

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Yes — that's a key advantage of ABTSR. Because the procedure removes a minimal amount of native bone, conversion to a conventional total shoulder replacement years later is straightforward if it ever becomes necessary.