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.
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 her initial story told me that they thought she was a bit incoherent when she came to the hospital.
The Tough Cases and Lasting Impacts Unfortunately, he still has limitations: mostly weakness and pain with lifting beyond 10 or 20 lbs. He also has difficulty supporting his weight on the involved arm. These impairments are likely permanent. We have talked about this on multiple occasions. Sadly, I cannot make everyone 100% better. These are … Read more
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
This is one of the most frequent questions that I get from patients. And it’s not an easy one to answer. Understanding the Complexity Of Shoulder Surgery Recovery New Research Provides Insight Recently a team at The Hospital for Joint Diseases led by one of my shoulder fellowship mentors Dr. Laith Jazrawi produced a study … Read more
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.
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.
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 help hold fractures together.
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 and patients use them, but in different ways.
