The meeting
Photographs from the Queensland Shoulder Society (QSS) Scientific Meeting, showing Kelly Macgroarty, QSS president, and Allan Wang.
The guest speaker
Allan Wang, a Perth orthopaedic surgeon and immediate past president of the Australian Shoulder Society (SESA), was guest speaker. He gave talks on rotator cuff tear surgery and on reverse total shoulder replacement, both of which were well received.
Also pictured are Ashish Gupta and Mark Robinson.
Rotator cuff tears and their repair
The rotator cuff is a group of four tendons that wrap around the top of the humerus and hold the ball centred in the socket while the larger muscles move the arm. Tears happen either suddenly, through a fall or a forceful pull, or gradually as the tendon wears over years. The usual symptoms are pain, often worse at night and when the arm is used above shoulder height, together with weakness. Some tears are managed without an operation, using physiotherapy to strengthen the remaining muscles and sometimes an injection to settle inflammation. Where repair is appropriate, the tendon is reattached to its footprint on the bone with anchors, most often arthroscopically, and is then protected for a period before graded strengthening begins. Not every tear can be repaired, and large tears of long standing may have retracted or the muscle may have wasted, which is one reason the subject remains a standing item at shoulder meetings. Individual results vary.
Reverse total shoulder replacement
Reverse replacement inverts the normal arrangement of the joint, placing a socket on the top of the humerus and a ball on the shoulder blade. This lets the deltoid muscle lift the arm in a shoulder where the rotator cuff is torn beyond repair or is no longer working, a situation in which an anatomic replacement would not function because it relies on those tendons. It is used for arthritis occurring alongside an irreparable cuff tear, for some fractures of the upper humerus, and in revision of earlier shoulder surgery. Individual results vary.