Click on this link to support shoulder education and research at the University of Washington.
Thanks to advances in the evaluation and treatment of disabling shoulder conditions, patients are receiving better care than ever before. Through the University of Washington Shoulder Research and Education Program, we are using cutting edge research techniques to identify the safest and most effective treatments for patients whose activities are limited by shoulder problems. We have learned that each shoulder in each patient is unique, and that optimal treatment identifies and respects this uniqueness.
Below are two examples demonstrating the personalization of the treatment for patients with shoulder disorders.
Treatment of shoulder arthritis with a total shoulder replacement or with the ream and run procedure. Conventionally, arthritis of the shoulder is treated by a total shoulder replacement (reaming the arthritic glenoid socket and covering it with a plastic implant - a procedure that may limit the recommended physical activities after surgery). Certain patients may prefer a procedure that is not associated with these limitations, the ream and run procedure (reaming the arthritic socket and avoiding the plastic socket), even though the recovery may be longer and more challenging.
In a recent publication (Minimum 10-year Follow-up of Anatomic Total Shoulder Arthroplasty and Ream-and- Run Arthroplasty for Primary Glenohumeral Osteoarthritis) we compared patients having each of these two procedures. We found that in comparison to patients having a total shoulder, patients electing the ream and run procedure were more likely to be healthy, young males having had prior shoulder surgery. Despite these differences, both groups of patients achieved excellent improvement in their comfort and function at 10 years after surgery. We concluded that appropriate selection of the type of surgery for each patient can optimize the outcomes.
Treatment of arthritis combined with a massive rotator cuff tear using either a reverse total shoulder or a special hemiarthroplasty. Conventionally, arthritis of shoulder arthritis combined with a massive rotator cuff tear has been treated with a reverse total shoulder (a reliable procedure, but with potential risks of fracture of the acromion, instability, and restricted motion). Certain patients may be more safely treated with a special CTA hemiarthroplasty (which can minimize the risk of these complications).
In a recent publication (Managing rotator cuff tear arthropathy: a role for cuff tear arthropathy hemiarthroplasty as well as reverse total shoulder arthroplasty) we compared patients having each of these two procedures. In comparison to patients having a reverse total shoulder, patients having the CTA hemiarthroplasty procedure were more likely to be males and to have the ability to actively raise their arm above the horizontal. Despite these differences, both groups of patients achieved the same amount of improvement in their comfort and function after surgery. Instability accounted for most of the reverse total shoulder complications; instability was not seen after the CTA hemiarthroplasty procedure. We concluded again that appropriate selection of the type of surgery for each patient can optimize the outcomes.
Other recent publications concerned risk factors for stiffness after the ream and run procedure (Risk Factors for Stiffness Requiring Intervention After Ream-and-Run Arthroplasty), predictors of success after the ream and run procedure (Factors associated with success of ream-and-run arthroplasty at a minimum of 5 years), predictors for success after treatment of shoulder infection (Predictors of success following single-stage revision shoulder arthroplasty: results at a mean of five-year follow-up in one hundred and twelve patients), revision of failed joint replacement (Revision of total shoulder arthroplasty to hemiarthroplasty: results at mean 5-year follow-up), and management of a loose plastic glenoid component after total shoulder replacement (What is the optimal management of a loose glenoid component after anatomic total shoulder arthroplasty: a systematic review?)
Currently underway are projects using Artificial Intelligence and Computer Vision to document critical landmarks on shoulder x-rays before and after surgery, so that these characteristics can be correlated with the outcome for each individual patient.
This work has four key characteristics
(1) It is focused on improving surgeons' ability to tailor treatment to the individual patient.
(2) Its new knowledge is continuously being shared worldwide through publications, presentations at meetings, the UW Shoulder and Elbow Fellowship, and the on-line UW Shoulder and Elbow Academy.
(3) It derived almost entirely from the systematic longitudinal patient followup program at the UW Shoulder Research and Education Program
(4) It would not be possible without ongoing generous gifts from patients, students, fellows, colleagues and the public to the endowments building permanent support for patient-centered shoulder research and education at the University of Washington.
If you would like to support the University of Washington Shoulder Research and Education Program, please click on this link; while there, check out the Donor Wall to see who has contributed so far.
Our goal is to increase the endowment to $2,000,000 - we're almost 2/3rds of the way there. Every gift is important.
If you would like to learn more about our shoulder research and education program, please send an email to matsenshoulder@uw.edu .
