Did you know the number of total shoulder arthroplasties (TSAs) / shoulder replacement surgeries performed in the United States increased by more than 200% between 2012 and 2022? That’s according to an article in the April 2026 Journal of Shoulder and Elbow Surgery.
That joint is also especially vulnerable to injury, dislocation and degeneration. As surgical techniques continue to advance and baby boomers continue to age, shoulder procedures are becoming increasingly common.
In this issue, we review the indications, surgical techniques, and perioperative considerations for TSA and other commonly performed shoulder procedures.
We also bring to your attention an article by NIFA’s own James Stobinski in the latest issue of OR Today magazine about the continued shift of surgical care from hospitals to ambulatory surgery centers (ASCs).
And scroll down for RNFA jobs and NIFA’s other favorite links.
Shoulder Surgery Resources
Shoulder Anatomy Basics
The shoulder provides an exceptional range of motion for reaching, lifting, throwing, and other complex movements. This mobility is made possible by four interconnected joints, the coordinated action of the clavicle, scapula, and humerus, and a network of muscles, tendons, ligaments and cartilage that provide dynamic stability. The primary joint is the ball and socket joint comprised of the top of the humerus (the ball) and the scapula’s glenoid cavity (the socket). Because the glenoid socket is relatively shallow, the shoulder relies heavily on the rotator cuff muscles, labrum, joint capsule, and healthy surrounding soft tissues to maintain alignment and function. Here’s a good illustrated summary of shoulder anatomy…
Watch this animated shoulder anatomy tutorial for a visual review of the bones, joints, ligaments, tendons, muscles, nerves, blood vessels, and bursae that work together to provide shoulder mobility and stability.
Types of Shoulder Surgery
When physical therapy and medication fail to relieve shoulder pain or restore function, surgical intervention may be indicated. This overview reviews the indications and basic techniques for common shoulder procedures, including rotator cuff repair, SLAP repair, total shoulder arthroplasty, arthroscopic stabilization for shoulder dislocation, arthroscopy for adhesive capsulitis (frozen shoulder), acromioclavicular (AC) joint repair, and arthroscopic decompression for shoulder impingement.
In addition, check out the following articles:
- Rotator Cuff Repair – Rotator cuff repair is one of the most commonly performed shoulder procedures and is indicated for symptomatic full or partial thickness tendon tears that have failed conservative management. See this 2021 article from the Journal of Clinical Orthopaedics and Trauma on current concepts in rotator cuff repair techniques. Learn More…
- Shoulder Arthroscopy (Debridement and Impingement Surgery) – Shoulder arthroscopy for debridement and impingement is a minimally invasive procedure used to diagnose and treat conditions that cause pain, inflammation, and restricted shoulder motion. This 2024 article from Arthroscopy Techniques addresses patient positioning and operating room setup. Learn More…
- Shoulder Replacement (Arthroplasty) – Total shoulder arthroplasty replaces both the humeral head and the glenoid surface, while reverse total shoulder arthroplasty changes the joint mechanics by placing the ball component on the glenoid and the socket component on the humerus, allowing the deltoid muscle to compensate when the rotator cuff is deficient. This article from the May 2026 Journal of Shoulder and Elbow Surgery explores indications, outcomes, and survivorship in patients younger than 50 years of age. Learn More…
Photo by Sebastian Kaulitzki on Adobe Stock
Videos
Rotator Cuff Repair
This video from the Hospital for Special Surgery, New York provides a detailed overview of surgical first assist techniques and operative approaches for arthroscopic rotator cuff repair.
Watch video. . .
Shoulder ArthroscopyThis video from the Bon Secours St. Francis Health System in Greenville, SC, provides an overview of shoulder arthroscopy, a minimally invasive procedure used to diagnose and treat conditions causing shoulder pain, limited range of motion, and joint dysfunction.
Watch video. . .
Reverse Total Shoulder ArthroplastyThis video from Romeo Orthopedics in Chicago demonstrates a reverse total shoulder arthroplasty performed by Dr. Romeo, highlighting the surgical technique and key steps involved in this increasingly common shoulder reconstruction procedure.
Watch video. . .
The Shift from Acute Inpatient Care to Outpatient and Ambulatory Care
While inpatient admissions have remained relatively flat since the 1980s, outpatient care and ambulatory surgery have experienced significant growth. In the July 1 issue of OR Today, NIFA’s James X. Stobinski, PhD, RN, CNOR(E), CSSM(E), CNAMB(E), explores this ongoing shift from acute inpatient care to ambulatory settings and examines its implications for hospitals, ambulatory surgery centers, and perioperative professionals.
Read the article here . . .
In The Spotlight: Bruce Curnuck
Credentials
RN
Student Status
Current student in NIFA’s RNFA program
City & State
Walla Walla, Washington
Current Position
Staff RN Circulator/Scrub
Where did you get your RN degree?
Avondale College, New South Wales, Australia
How did you come to choose perioperative nursing?
I did an undergrad work rotation in the OR and never left. It just fit.
What is one funny, scary or unique moment you’ve experienced at the table?
I had my scrub pants fall off while scrubbing a stat hysterectomy for postpartum hemorrhage (and yes, the patient made it). I wasn’t even on call that night; the call team was already doing a case and they had this emergency and started calling every nurse on the roster. Needless to say, when the drawstring started to slip no one had any time to help! I already had my gown on, sooooo . . . I just stepped out of my clogs, kicked my scrub pants off and did the case in my undies.
The floor was COVERED in blood and trash, the patient had received 8 units of blood before getting to the OR; I don’t remember how much in the OR. As the case ended and the patient stabilized, the circulator started putting all the trash and linen in the appropriate bags. No one knew my pants were gone so they just got picked up and put in the linen. ICU came down to pick up the patient directly from the OR. The ICU nurse had quite the surprise on her face when I pulled my gown off and walked down the hall to get new scrubs!
What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
I learned a lot at the class, its hard to narrow it down to a single thing. Maybe that there are always new and different ways to do things and to stay open to learning from colleagues and physicians.
How do you feel having your RNFA will impact your life/career?
??????I think it will help me provide the best care I can to our patient.
NIFA – Office Hours
Monday-Thursday, 8:00am – 4:00pm
Friday, 8:00am – 3:00pm
Practice Resources
Here are several of the most-in-demand sites for our students, prospective students and grads:
Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.
The human shoulder is a marvel of engineering. Its ball and socket joint is generally considered the most mobile joint in the body, able to move in more directions than any of our other joints. It’s stabilized by an intricate network of muscles, ligaments, tendons and cartilage. 