At the SESA meeting in Darwin
Dr Cutbush attended the Shoulder and Elbow Society of Australia (SESA) Annual Scientific Meeting in Darwin in August 2016, presenting a paper titled "Complications of Arthroscopic Latarjet Surgery".
Presenting one's own complications is not comfortable, but it is how a technique's limitations become known and how other surgeons learn to avoid the same problems.
What the Shoulder and Elbow Society of Australia is
SESA is the national society for Australian orthopaedic surgeons whose practice concentrates on the shoulder and elbow. Its annual scientific meeting is where members present their research and their results to each other, where the training of shoulder fellows is discussed, and where positions on contested questions of practice gradually settle.
A subspecialty society meeting works differently from a general orthopaedic congress. Everyone in the room performs the same small set of operations, which means a paper can be questioned in detail by people who will immediately recognise whether the account of a difficult case rings true. That is uncomfortable for the presenter and useful for everyone else.
The Latarjet procedure, in plain terms
The shoulder is a ball sitting against a shallow socket, which is what gives it such a wide range of movement and also what makes it the joint most likely to dislocate. Repeated dislocations can wear bone away from the front rim of the socket. Once enough bone has gone, repairing the torn soft tissues alone may not be enough to keep the joint in place, because the socket itself is now too small.
A Latarjet procedure addresses that by moving a small piece of bone, the coracoid process, from just in front of the shoulder to the front of the socket, where it is fixed in position. It brings its attached muscle with it, which adds a sling across the front of the joint. Traditionally this was done through an open incision; doing it arthroscopically means working through small incisions with a camera. Individual results vary.
Why complications are presented
Any operation that involves moving and fixing a piece of bone close to nerves and blood vessels has a specific set of things that can go wrong, and an arthroscopic version of such an operation has its own again. A paper on complications sets out what those are, how often they were encountered, how they were managed and what was changed afterwards. Published series of this kind are how a technique's limits become part of the shared knowledge of the specialty rather than something each surgeon has to discover independently.
Related information
- The shoulder instability page.
- The Latarjet and labral repair page.
- The anterior instability page.
- Our post on the talk on Latarjet complications at the Royal North Shore Shoulder Symposium.