Shoulder Balloon Spacer: up, up and away? Or full of hot air? (continued…)
Based on their evidence the authors of the START: REACTS trial recommended against the balloon as they found no benefit in the intervention group and in some subgroups found net harm compared to their control group. They noticed worse clinical outcome results especially in women, with some showing increase in pain in the test group…
Continue Reading Shoulder Balloon Spacer: up, up and away? Or full of hot air? (continued…)
Shoulder Balloon Spacer: up, up and away? Or full of hot air?
Inspace Blog Post Follow up: Review of the papers This is an update to a previous blog post I wrote about the Inspace balloon. Since the original post, the full results of the FDA pivotal trial have been published in the peer reviewed literature in a prestigious orthopedic journal: The Journal of Bone and Joint…
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Surgeons That Perform More Shoulder Replacements Have less Complications
A recent presentation at the American Academy of Orthopedic Surgeons annual meeting by Harvard Professor Jon J.P. Warner M.D. concluded that when shoulder surgeons perform a higher volume of shoulder replacement procedures, they have lower complication rates. Shoulder replacement is a technically demanding procedure. To master the procedure surgeons need many years of training. This…
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Can a New Balloon Implant Fix Your Irreparable Rotator Cuff Tear?
Disclosure: I have no financial relationship with any orthopedic implant manufacturer including Stryker the owner of the technology that this post discusses. You are about to start hearing more about a relatively new technology for treating massive rotator cuff tears. I say “relatively new” because the technology has been available in Europe and a few…
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Buffalo, NY Team Wins Award for Research on Shoulder Replacement Surgery
Shoulder replacement is an excellent operation for many people with shoulder arthritis. Our Buffalo, NY based team is actively researching ways to make it better. Last week I was honored to accept the Charles Neer award from the American Shoulder and Elbow Society on behalf of our team at University at Buffalo/ UBMD Orthopedics and…
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Unstable Shoulder: will an operation always work?
Most patients, who have new instability after a surgery to fix shoulder instability, DON’T want more surgery. http://www.healio.com/orthopedics/arthroscopy/news/online/%7B207d5985-69ec-43db-8fd8-6971b6357b84%7D/speaker-most-patients-with-instability-do-not-have-additional-surgery-after-bankart-repair A 2014 paper presentation at the Arthroscopy Association of North America found that patients who had surgery to stabilize a dislocating shoulder had about a 1 in 4 chance of having another episode of dislocation or subluxation…
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Slipping on Ice Can Lead to Serious Shoulder Injury in Buffalo, NY
Winter can be unpredictable in Buffalo, NY. That can sometimes spell bad news for your shoulder. Even though snow can be beautiful it can sometimes lead to slippery conditions that can result in unexpected problems. One of the most common types of injuries that I see in the winter are shoulder injuries after a slip…
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Do Rotator Cuff Tears Get Bigger Over Time?
I have noted in other posts that rotator cuff tears can cause a lot of confusion. Let’s assume that your doctor has diagnosed you with a rotator cuff tear. He or she presents you with a few options: physical therapy, injections, surgery. You have a small tear. You are in a lot of pain, but…
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How Long Will Rehabilitation Take After Rotator Cuff Surgery? The Answer Usually Depends on One Key Factor.
Being told that you need rotator cuff surgery can be an intimidating prospect. Physical Therapy after Surgery One of the main concerns is how much physical therapy you will need after surgery. How long will therapy take? And when will you finally be back doing what you want to do? The truth is, most people…
One Exercise That Has Been Proven to Help Tennis Elbow Pain
There is a certain exercise that I assign all of my tennis elbow patients. You will find it in the video below. It’s the one exercise that has proven effective by medical science in treating tennis elbow (lateral epicondylitis is the fancy way of saying it). The trick to the exercise is pace: SLOOOOOW on…
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Safe Surgery
One of patient’s biggest fears before they are about to undergo an operation may be that their surgeon operates on the correct body part. In medicine wrong site surgery is referred to as a “never” event: it should never happen. And while extraordinarily rare, it still occasionally does happen. Usually when it does, it makes…
How to Keep Your Glasses from Fogging When Wearing a Face Mask
Here’s a video post that is timely for our COVID19 times. It’s a little trick that I use in the OR to prevent my eye shields from fogging in the OR when I wear a mask. Tape the bridge of the nose. This video shows how.
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Anchors: Do They Come Out?
As we mentioned in a previous post, most suture anchors stay in your bone for life. The technology has advanced to such a degree, that they are extraordinarily reliable and rarely come out. While we don’t have exact numbers, our experience as surgeons tells us that it is rare for them to “back-out” of bone…
Anchors Away: Tiny Devices That Can Help Your Shoulder in A Big Way
When I am explaining rotator cuff surgery to patients, one of the most common questions I get is, “How do you repair the tear?” My answer typically involves an explanation of some basics about rotator cuff tears: (more…)
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Four Types of Patients
One of the most interesting parts of my job is that I get to interact with so many different types of people on a regular basis. Their different personality types color many of the decisions we make in the office more than most people realize. When you are studying to be a doctor, much of…
Smoking is Bad for Your Shoulder Too
We highlighted an article a while ago about how smoking was bad for your bones in general. It not only leads to osteoporosis (weak bone) but can lead to poor healing if you are unlucky enough to break a bone. (more…)
Don’t Let Your Bones Go Up In Smoke
Most people know that smoking is bad for your heart and lungs. Few people know that it’s bad for your bones and joints. There’s a host of reasons why smoking leads to poor bone health. And I’m not sure how interested you are in the nitty gritty bichemical details of why this is. So I…
Should You Exercise Before Shoulder Surgery?
The other day a patient asked me if he should exercise his shoulder before getting a shoulder replacement. A little background, the patient is about 60 years old and is an avid weight lifter. I was a little confused by the question so I asked him to clarify. He thought that if he increased his…
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Will Your Rotator Cuff Retear After Surgery?
Rotator cuff tears can be tricky. And unfortunately not all rotator cuff repairs are fool proof. Older studies showed that rotator cuff repairs failed to heal in up to 3/4 of attempts in some patients. Newer studies tend to show more favorable results but on average still report at least a 1/4 chance of retiring…
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When NOT to Repair a Labrum Tear in Your Shoulder
If you have a torn labrum in your shoulder, repairing the labrum is not always the right answer. Read more to find out why. I once saw a patient who had undergone three previous shoulder surgeries over the course of four years by another surgeon. All of the surgeries were arthroscopic surgeries. Two of those…
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Physical Activity
Research has shown that the ability to walk unassisted is likely the single most important factor in maintaining your independence as you age. Targeting this simple metric may offer the secret to staying independent and new research supports this conclusion. A recent study of over 1600 men and women in their 70’s and 80’s with…
Frozen Shoulder: A Team Approach May Offer New Hope For Relief
Frozen shoulder is one of the most frustrating problems for patients and doctors alike. It’s painful, it comes out of nowhere, it causes sleepless nights and it often seems to drag on forever – 12 months is not uncommon. As doctors we like quick fixes as much as you do. So it’s hard to see…
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Shoulder Arthritis: is MRI necessary?
If you have shoulder arthritis, an MRI may give you more information than you bargained for. Most people think that you need an MRI to “see” everything that is going on in your shoulder. But it’s simply not true. And there are a few ways that you can be fooled by this line of reasoning.…
Obesity: Did You Know It Was Bad For Your Elbow?
A recent study from the Mayo Clinic examined the relationship between clinical outcome and obesity in elbow replacement patients. The Mayo Clinic has the most extensive experience with elbow replacement in the world. They studied a large group of patients and approximately one quarter of these patients met the definition of obesity. Overall obese patients…
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Shoulder Dislocation in Adolescents: There’s Still A Lot To Learn
We don’t know a millionth of one percent about anything. Thomas Edison A recent presentation at the American Arthroscopy Association of North America tried to answer the question of why some adolescents re-dislocate their shoulder and others do not after shoulder instability repair. (more…)
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You Can’t Judge A Book By Its Cover
I take call about 5-6 days per month which means that I take care of patients that come into the hospital with fractures. A few weeks ago I treated a woman who had a hip fracture (I treat a lot of hip, ankle and wrist fractures when on call). The ER staff who gave me…
Sex and Shoulder Pain: It’s an Issue
I saw a patient recently that I have been treating for a few years. He originally sustained a very bad trauma – a gunshot wound to his dominant arm and was in his early 40’s at the time of the incident. His injury was so bad that it required a shoulder replacement as the ball…
Should You Wear A Sling After Shoulder Surgery?
A recent study in the Journal of Shoulder and Elbow Surgery compared outcomes of patients who had rotator cuff surgery based on how faithful they were with wearing their sling. They asked 50 patients undergoing rotator cuff repair to wear an abduction sling for the first (more…)
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“When Can I Drive After Surgery?”
This is one of the most frequent questions that I get from patients. And it’s not an easy one to answer. Recently a team at The Hospital for Joint Diseases led by one of my shoulder fellowship mentors Dr. Laith Jazrawi produced a study that makes some recommendations about safe driving after labrum and rotator…
When Having More Money May Be Bad For Your Kids’ Health
More money, more problems The Notorius B.I.G. There is a class of health research focused on relating socioeconomic status with overall health outcomes. In most cases if you have more money, you have better health. (more…)
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Rotator Cuff Tears: Stranger Than You’d Think
No doubt about it, rotator cuff tears can be confusing. It’s not that you can’t understand the idea of having a tear in your tendon. That’s easy. It’s just that treating them can be counterintutive: some get better with therapy and others don’t. Some cause significant pain and others don’t. Some need surgery and others don’t. (more…)
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“Do The Implants Have To Come Out?”
As a shoulder and elbow surgeon a lot of operations that I perform involve implanting hardware to help solve someone’s problem. Examples of hardware include plates and screws, joint replacement implants and arthroscopic anchors. When someone asks whether hardware needs to be removed in the future they usually are referring to plates and screws that…
How Do You Know If Your Orthopedic Surgeon Is Good?
Heuristics are “rules of thumb” that people use to make decisions in situations that involve uncertainty. Taleb writes about them in depth and I enjoy his writing. The daily practice of medicine requires making frequent high stakes decision with incomplete knowledge. Where “evidence based medicine” leaves off, heuristics often take over. I think both doctors…
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Shoulder Arthritis: Two Truths
I saw a patient in the office recently whose x-rays were a testament to two important points about shoulder arthritis: For a given patient, shoulder arthritis in the ball and socket portion of the joint usually occurs in both arms. (more…)
Bone Loss and Shoulder Dislocations: An Insidious Problem
A study from the recent American Arthroscopy Association of North America outlines risk factors for poor outcomes after surgery in patients who have had dislocations. Background: Steve Burkhart popularized the concept of the inverted pear-shaped socket. He found that if more than 1/4 of the bone was missing from the socket after a dislocation and…
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What To Do About Shoulder Arthritis?
There is more than one joint in the shoulder. What you choose to do about your shoulder arthritis depends on where the arthritis is and how severe it is. Below is a typical case of severe arthritis in the ball and socket portion of the shoulder joint. Arthritis is actually relatively uncommon in this joint.…
Introduction
Thanks for visiting my blog. It is focused on issues pertaining to shoulder and elbow conditions and shoulder and elbow surgery. I will share my personal insights with you as a practicing shoulder and elbow surgeon.
Not Sure, It Just Hurts
Get safe, reliable results. Eliminate your shoulder pain so you can move, live, and sleep better
I Have a Torn Rotator Cuff
Not all rotator cuff tears need surgery. Find out if you can restore your shoulder health without surgery.
I Need a Shoulder Replacement
Walk through the pros and cons of shoulder replacement surgery with an experienced surgeon.