A lecture on the history of shoulder surgery
Dr Kenneth Cutbush introduced Prof David Sonnabend's talk to QUT engineering students on the history of shoulder surgery in Australia, given in person and over Zoom.
About Professor Sonnabend
Prof Sonnabend is an Advisory Board member of the ARC Training Centre for Joint Biomechanics, Emeritus Professor at the University of Sydney, and a founding member of SESA. He has published over 70 papers and 18 book chapters, and his doctoral work concerned the rotator cuff.
He performed the first rotator cuff repair in Australia, and was among the first in Australia to perform a reverse total shoulder replacement, around 1999. He has been an inspiration to a generation of shoulder surgeons here.
Why engineering students
Shoulder surgery and engineering overlap more than might be expected. An artificial joint is a mechanical device that has to work inside living tissue for decades, and the questions it raises are engineering questions: how load passes through an implant and into bone, how two surfaces wear against each other, how a fixation point behaves under repeated stress, how the muscles around a joint balance it. A training centre for joint biomechanics exists to put surgeons and engineers on the same problems, which usually means surgeons describing what fails in practice and engineers testing why. A lecture on how shoulder surgery developed in Australia gives students the clinical context for the devices they will be asked to model and design.
What a reverse total shoulder replacement is
In a normal shoulder the ball sits on the arm bone and the socket on the shoulder blade. A reverse replacement swaps that arrangement over: a metal ball is fixed to the shoulder blade and a socket is fitted to the top of the arm bone. The reason for doing so is that the reversed geometry allows the deltoid, the large muscle over the outside of the shoulder, to raise the arm without help from the rotator cuff. That makes it relevant where the rotator cuff is torn beyond repair, where arthritis has developed alongside cuff damage, and in some complex fractures. Its introduction in Australia at the end of the 1990s gave surgeons an option for shoulders that previously had few. Whether it is suitable in a given case depends on the individual assessment. Individual results vary.