The summit
The inaugural M.O.R.E. Australian Shoulder Summit, hosted by Medacta International at the InterContinental Hotel, Double Bay, Sydney.
Meetings of this kind are organised as educational programmes for surgeons, with a faculty of surgeons presenting their own results and techniques and the programme divided into themed scientific sessions. The value for those attending is the chance to hear several surgeons address the same problem in sequence and to question them on where they disagree.
Pre-operative planning and range of motion
The first talk, in Scientific Session 2 on pre-operative planning, concerned improving range of motion in reverse shoulder arthroplasty through structured planning.
The connection between the two is not obvious to patients but is central to the operation. A reverse replacement changes the geometry of the shoulder, and the positions and sizes chosen for the components determine where the arm can move before it meets a mechanical limit. Planning those choices on the patient's own CT scan, rather than deciding them in theatre, is how the available movement is maximised for that particular shoulder.
A reverse shoulder arthroplasty itself replaces the joint with the ball and socket swapped over: a ball is fixed to the shoulder blade and a socket to the upper end of the arm bone. That arrangement lets the deltoid muscle raise the arm in shoulders where the rotator cuff tendons can no longer do it, which is why the operation is used for arthritis with a deficient cuff and for some fractures and failed previous replacements. Individual results vary.
New technology and complex cases
A second talk later the same day covered new technology and complex arthroplasty cases, meaning shoulders with significant bone loss, previous surgery or unusual anatomy, where standard approaches do not straightforwardly apply.
Those are the cases in which planning software and custom implants earn their place, because there is less normal anatomy left to guide the operation and less margin for correcting a decision once the implant is in.
Good to see Fellows and colleagues at the meeting, including Dr Ashish Gupta. With thanks to Medacta for hosting.
Related information
- Our reverse total shoulder replacement page
- Our shoulder arthritis page
- Our post on pre-operative planning and rehabilitation