* What are the best predictors of clinical success in the non-operative and surgical management of a chronic symptomatic rotator cuff defect: patient factors (age, BMI, activity, employment status, insurance coverage, smoking status, emotional health, physical health, ASA classification, expectations of the outcome) shoulder factors (tear size, chronicity, comfort, function, strength, fatty infiltration, prior surgery), treatment factors (exercises, injections, non-repair surgery, repair surgery, repair method, post surgery rehabilitation) and resulting rotator cuff integrity.
*What are the best predictors of clinical success in surgical management of glenohumeral arthritis: patient factors (age, BMI, activity, employment status, insurance coverage, smoking status, emotional health, physical health, ASA classification, expectations of the outcome) shoulder factors (diagnosis, radiographic anatomy, rotator cuff status, chronicity, comfort, function, strength, prior surgery), and treatment factors (prosthesis type, surgical technique, post surgery rehabilitation).
*Why do we not have a shoulder arthroplasty registry in the United States that would enable us to analyze the outcomes of this procedure for all surgeons and all patients, rather than having our knowledge confined to what we can glean from case reports from individual centers that represent a highly selected and non-representative subset of the national experience? Why do we not require that implant manufacturers support such an effort through a mandatory levy as they do in some other countries?
*In that each year sees a new ‘crop’ of ‘innovative’ new shoulder implants, how can we assess the value added (=incremental benefit to the patient/incremental cost) of new implants?
*What is the optimal strategy for detecting bacteria in the wounds of shoulders coming for revision arthroplasty, recognizing that Propionibacterium and coagulase negative staph do not incite the inflammatory response traditionally associated with perprosthetic hip and knee arthroplasty infections? What are are the pathogenetic and therapeutic implications of positive deep cultures for these organisms?
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