End of the fellowship year
Farewell to Dr Wu Kang and Dr Mirek Karel, who have completed the twelve-month Brisbane Shoulder Fellowship.
Where they go next
Dr Wu is moving to Canada for a fellowship with George Athwal in London, Ontario. He has prepared two research papers for publication during his year here.
Dr Mirek is finishing a book chapter on arthroscopic Latarjet and revision problems in shoulder instability, written with Ashish Gupta. He begins a fellowship with Tjarco Alta and Arthur van Noort in July 2024.
We hope to collaborate with them again, and wish them well.
What the fellowship year involves
A fellow is a surgeon who has already completed specialist orthopaedic training. The twelve months are spent concentrating on one region of the body: operating with and assisting the supervising surgeons, running clinics, assessing new referrals, following patients through their recovery, and seeing how complications are recognised and managed. Alongside that sit research and the teaching of registrars. The purpose is concentration and volume, so that patterns become familiar and judgement develops about which treatment suits which situation rather than which operation the surgeon happens to know. Individual results vary.
Why fellows write and publish
Research and writing are a formal part of a fellowship year rather than an optional extra. Writing up a series of cases requires that the results be gathered, checked and set out in a form others can examine, which is a discipline distinct from operating. A book chapter imposes a different demand again, since it has to summarise what is established, state fairly where opinion is divided, and be defensible to readers who will rely on it. Both routes put the author's reasoning in front of reviewers who are free to disagree.
Revision problems in shoulder instability
When a stabilisation operation fails and the shoulder dislocates again, the second operation is more difficult than the first. There is scar tissue from the earlier surgery, there may be anchors or screws already in the bone, and the socket has usually lost further bone both from the repeated dislocations and from the previous procedure. The options include transferring bone to rebuild the rim, as in a Latarjet, reconstructing the rim with a graft, and addressing a dent in the humeral head with a remplissage. Choosing between them depends on what has already been done and what bone remains. Individual results vary.