The evening
The Queensland Shoulder Society held a dinner evening in May 2015, with guest speaker Dr Alan Barber of Houston, Texas. The event was well attended.
What a scientific evening is
A state shoulder society is a small professional group of the surgeons, and often the physiotherapists and researchers, in one region who work on the shoulder. Rather than a full congress, it meets in the evening several times a year. The usual format is an invited lecture followed by one or two cases presented for discussion, with the audience free to disagree. These meetings count towards the continuing professional development that surgeons are required to maintain, but their practical function is simpler: they are where local practice gets compared, and where a surgeon can put a difficult case in front of colleagues who see the same problems.
The topics
Dr Barber covered biomaterials in shoulder surgery, particularly the anchors used in stabilisation and rotator cuff repair, and discussed the advantages and disadvantages of double-row versus single-row rotator cuff repair.
That last question has been debated for years. A double-row repair restores a broader contact area between tendon and bone, which has a theoretical advantage for healing, but it takes longer and uses more anchors, and the clinical evidence has not consistently favoured one over the other for all tear sizes.
Dr Cutbush joined the discussion panel and presented a clinical case.
What a suture anchor does
Tendon and ligament cannot be stitched directly to bone, so a small anchor is set into the bone and the sutures attached to it are used to hold the soft tissue against the surface while it heals. Anchors are placed through keyhole portals during arthroscopic surgery, which is what makes repairs of this kind possible without opening the joint. They are made in several materials: metal, hard plastics, and absorbable or part-absorbable compounds that are taken up by the body over time. Each involves a trade-off between strength, how the bone responds around it, and what is left behind if the shoulder ever needs further surgery, which is why biomaterials are a recurring subject at meetings like this one. The choice is a surgical judgement in each case. Individual results vary.