The meeting
On the faculty of the Shoulder Arthroplasty Masters Meeting 2018 in Sydney. The international guests were Gilles Walch, of Lyon in France, and George Athwal, of London, Ontario in Canada.
With thanks to Ashish Gupta for chairing, and to Wright Medical for sponsoring the meeting.
What a masters meeting is for
A masters meeting is a small, narrow format aimed at surgeons who already perform the operation in question regularly. The programme assumes the basics and spends its time on the cases that do not follow the pattern: the socket that has worn away unevenly, the shoulder that has had previous surgery, the replacement that needs revising. International guests are invited because the number of such cases any one surgeon sees is limited, so comparing how a handful of high volume units approach them is often the only way to make progress.
The discussion format matters as much as the talks. A room of twenty or thirty surgeons can argue a point to a conclusion, which a lecture theatre of several hundred cannot. Meetings of this kind are also where differences between countries surface, since implant availability, registry data and funding arrangements all shape what is considered standard practice.
Shoulder arthroplasty, in plain terms
Arthroplasty means joint replacement. In the shoulder, the joint is a ball at the top of the upper arm bone sitting against a shallow socket on the shoulder blade. Arthritis wears away the smooth cartilage on those two surfaces, so that bone grinds against bone, which causes pain and stiffness and often disturbs sleep. A replacement removes the worn surfaces and substitutes components for them.
An anatomic total shoulder replacement reproduces the normal arrangement, with a ball on the arm bone and a socket on the shoulder blade. It depends on the rotator cuff tendons still working. A reverse total shoulder replacement turns that around, placing the ball on the shoulder blade and the socket on the arm bone, so the deltoid muscle can lift the arm when the rotator cuff cannot. Choosing between the two, and planning where the components should sit in a shoulder whose bone has already been reshaped by arthritis, is most of what a meeting on arthroplasty is concerned with. Individual results vary.
Related information
- The anatomic total shoulder replacement page.
- The reverse total shoulder replacement page.
- Our post on Gilles Walch.
- Our post on George Athwal.