At ICSES in Jeju
Dr Kenneth Cutbush attended the 13th International Congress of Shoulder and Elbow Surgeons in Jeju, Korea, in May 2016, presenting the scientific paper "Arthroscopic Latarjet with Labral Repair" on day one.
Pictured with Dr Adam Dalgleish and Dr Simon Printz.
What ICSES is
The International Congress of Shoulder and Elbow Surgeons is the congress of the international body that brings together the national and regional shoulder and elbow societies. It is held every two years and moves between host countries, and it functions as the point at which work from the different regional groups is presented to the whole field rather than within one country's meeting. Being the thirteenth congress indicates how long the series has been running.
The programme is made up of submitted scientific papers reviewed before acceptance, invited lectures, instructional sessions and symposia on contested topics. Presenting a paper there means the work is open to questions from surgeons who treat the same problem in different health systems, which is a reasonable test of whether a technique or a finding holds up outside the unit that produced it.
The Latarjet procedure and labral repair
The shoulder is a shallow ball and socket joint, which is what allows its range of movement and also what makes it the joint most likely to dislocate. The socket, the glenoid, is rimmed by a ring of cartilage called the labrum, and the ligaments that restrain the joint attach to it. When a shoulder dislocates, the labrum and those attachments are commonly torn, and the joint can then dislocate repeatedly.
Where the bone of the socket is intact, repairing the torn labrum back to the rim may be enough. Where bone has been lost from the front of the socket, a repair alone has less to work with, and a bone block procedure may be considered. The Latarjet procedure transfers a small piece of bone, the coracoid, with its attached tendon, to the front of the socket, which both deepens the socket and adds a restraining sling of soft tissue. Doing the procedure arthroscopically means working through small portals with a camera rather than through an open incision. Combining the bone transfer with repair of the labrum addresses both elements in one operation. Which approach suits a particular shoulder depends on the examination, the imaging and the amount of bone loss. Individual results vary.