Source: MD India
According to research presented today at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting in Chicago, IL, arthroscopic bankart repair surgery is a cost-effective approach for patients suffering their first shoulder dislocation.
"We based our conclusions on a Markov model, which takes into account how surgery affects the patient’s recovery in relation to the actual costs of medical treatment," commented Ryan P. Donegan, MD, MS, from Dartmouth-Hitchcock Medical Center in Lebanon, NH. "For surgery to be cost-effective in this model, expenses must be under $24,457, the probability of re-dislocation must be under 7 percent, and the quality of life rating must not fall below 0.86. Our research showed surgical costs of $11,267, probability of re-dislocation at only 4 percent and quality of life rating of 0.93 – numbers suggesting surgery is a good investment for these patients."
Source: MD India
Existing rehabilitation used for people undergoing tendon-bone repairs like rotator cuff repair perhaps partially to blame for the high rates of failed healing post-surgery suggests study by a new Hospital for Special Surgery. Experiments in a rat model of this injury suggest that immobilizing the limb for four to six weeks after surgery, rather than quickly starting physical therapy, improves healing.
"Before we did this study, we thought that delaying motion for a short period of time, seven to ten days, and then starting physical therapy would be the most beneficial to tendon healing. However, from the data in this study, it appears we should be immobilizing our patients for longer periods of time," said Scott Rodeo, M.D., principal investigator of the study and co-chief of the Sports Medicine and Shoulder Service at Hospital for Special Surgery (HSS) in New York City.
Question: I am considering having my shoulder replaced. What questions should I be asking my doctor?
Answer: The decision to replace your shoulder joint is a very serious one. The most important factor in choosing a surgeon is their experience.
A study that was published out of Duke University in 2004 demonstrated that the risk of a post-operative complication was reduced by more than 50 percent when surgeons performed a high volume of shoulder replacements in a high-volume hospital, compared to surgeons and hospitals performing relatively few of these procedures. This high volume is typical of shoulder fellowship-trained surgeons.
Source: Medscape News
Arthroscopic capsulolabral posterior reconstruction offers advantages in posterior shoulder instability, according to researchers.
More than 90% of athletes treated for the condition in this manner are able to return to sports, Dr. James P. Bradley told Reuters Health by email.
While glenohumeral instability is relatively common, affecting 2% of the general population, posterior instability is much rarer, affecting 2% to 10% of all unstable shoulders, according to a 2011 paper in Sports Medicine. Posterior glenohumeral instability is mainly seen in athletes.
In a June 26 online paper in The American Journal of Sports Medicine, Dr. Bradley of the University of Pittsburgh Medical Center and colleagues observe that there are few reports of arthroscopic treatment of unidirectional posterior shoulder instability.
The common belief that rheumatoid arthritis patients don’t benefit from knee replacement surgery as much as those with the more common osteoarthritis has been challenged by the findings from a pair of studies by New York City scientists.