Shoulder surgery at Texas Orthobiologics is performed by Don Buford, M.D., a board-certified orthopedic surgeon, sports medicine fellowship-trained, with more than twenty-five years operating in Dallas. The shoulder procedures here are sports medicine procedures — repairing and stabilising the rotator cuff, the labrum and the ligaments, mostly arthroscopically.
What is unusual about this practice is not the surgery. It is that the same surgeon also performs the orthobiologic injections that are the alternative to it. The recommendation you get is therefore not decided by what is on offer.
Shoulder procedures performed here
Arthroscopic rotator cuff repair
The rotator cuff is the group of four tendons that hold the shoulder centred and drive overhead motion. When one tears through its full thickness, the tendon has to be brought back to bone and held there while it heals. That is a repair, not a resurfacing, and it is done arthroscopically — through small portals, with a camera.
Not every cuff tear needs repairing. Partial-thickness tears and chronic tendinopathy are frequently better served by a biologic than by an operation, and that is a genuine fork in the road rather than a marketing line. Where the tear sits, how far it has retracted, how good the tissue and the muscle look, your age and what you need the arm to do all move the decision.
Labral and SLAP repair
The labrum is the rim of cartilage around the socket that deepens it and anchors the capsule and the biceps tendon. A SLAP tear is a specific pattern of labral injury at the top of the socket where the long head of the biceps attaches.
Labral tears are among the most over-treated findings in shoulder surgery, because they show up on scans in people whose shoulders do not hurt. The decision rests on whether the labral tear is actually generating your symptoms — which is an examination question before it is an imaging question.
Shoulder instability surgery
A shoulder that dislocates or subluxes repeatedly has usually damaged the labrum, the capsule, or the bone of the socket rim. Surgery re-tensions and re-anchors those structures so the joint stays where it belongs. The number of previous dislocations, your age, the sport you play and whether there is bone loss all change what the right operation is.
AC joint procedures and biceps tenodesis
The acromioclavicular joint at the top of the shoulder can be a pain source in its own right after injury or with wear. The long head of the biceps tendon is another, and when it is the culprit a tenodesis moves its attachment to a place where it stops hurting. Both are frequently done alongside a cuff or labral procedure rather than on their own.
This list is the sports medicine shoulder scope of this practice. It does not include shoulder replacement, which is not performed here.
How the decision to operate gets made
An operation is a good idea when the structural problem on the scan is the thing generating your symptoms, and when repairing it is likely to change how the shoulder works. Neither half of that is a given.
The parts of the visit that actually decide it:
- The examination. Which movements reproduce the pain, where the weakness is, whether the joint is stable under load. Imaging is read against an examination, not in place of one.
- What the tissue looks like. A retracted, poor-quality tendon with a wasted muscle behaves differently from a fresh tear in a healthy one, and it changes what a repair can realistically achieve.
- Whether a biologic is the better first move. For chronic cuff tendinopathy and many partial tears it often is.
- What you need the shoulder to do, and what recovery you can commit to.
If an operation is unlikely to help your particular shoulder, you will be told that at the visit rather than after it.
Recovery after shoulder surgery
Recovery from a shoulder repair is measured in months, not weeks, and rehabilitation is the part that determines the result. A repaired tendon has to heal to bone before it can be loaded, so early motion, later strengthening and eventual return to sport are each advanced on a protocol rather than on how the shoulder feels on the day.
The protocol depends on which procedure was done, what was found at surgery, the quality of the tissue repaired and whether anything else was addressed at the same time. It is established individually and given to you before surgery rather than afterwards, so the commitment is clear while the decision is still being made. That is the right thing to ask about at the consultation.
Why it matters that both are on the table
Most practices in this market do one thing. An injection clinic cannot operate, so an injection is the only recommendation available to it. A surgical practice frequently does not offer well-prepared orthobiologics, so that conversation never really happens.
Dr. Buford does both. He performs the operations on this page, and he performs platelet-rich plasma and bone marrow concentrate injections himself, under ultrasound guidance, in the office. That means the question at the consultation can be the right one — what does the shoulder actually need — rather than a question shaped by what the practice is equipped to sell.
Sometimes the answer is an operation. Sometimes it is a biologic. Sometimes it is neither, and you will be told that too.
Request an appointment or call (877) 777-8883.
Common questions
Do you perform rotator cuff repair in Dallas?
Yes. Arthroscopic rotator cuff repair is one of the shoulder procedures performed here by Don Buford, M.D., a board-certified orthopedic surgeon who is sports medicine fellowship-trained. Not every cuff tear needs repairing, though - partial-thickness tears and chronic tendinopathy are frequently better served by an orthobiologic injection, and both options are available in this practice.
Does a rotator cuff tear always need surgery?
No. Full-thickness tears that have retracted generally need repairing, because the tendon has to be brought back to bone. Partial-thickness tears and chronic tendinopathy often respond to an orthobiologic injection instead. Where the tear sits, how far it has retracted, the quality of the tendon and muscle, your age and what you need the arm to do all move the decision.
What shoulder procedures do you perform?
Arthroscopic rotator cuff repair, labral and SLAP repair, shoulder instability surgery, acromioclavicular joint procedures and biceps tenodesis. These are sports medicine shoulder procedures. Shoulder replacement is not performed here.
Do I need surgery for a labral tear?
Not necessarily. Labral tears show up on scans in plenty of people whose shoulders do not hurt, which makes them one of the most over-treated findings in shoulder surgery. The question is whether the labral tear is actually generating your symptoms, and that is settled by examination read against the imaging rather than by the scan alone.
How long is recovery after shoulder surgery?
Months rather than weeks, and rehabilitation is the part that determines the result. A repaired tendon has to heal to bone before it can be loaded, so motion, strengthening and return to sport are each advanced on a protocol. The protocol depends on the procedure, what was found at surgery, the quality of the tissue repaired and whether anything else was addressed at the same time. It is established individually and given to you before surgery.
Can I get a second opinion on shoulder surgery I have been recommended?
Yes, and it is a common reason patients come here. A second opinion is specifically useful when you have been told you need an operation and want to know whether that is the only reasonable option.
