In Detroit
A visit to Professor Michael Wiater in Detroit, with a day spent in the operating theatre learning techniques in shoulder replacement surgery.
Why surgeons visit each other
Visiting another surgeon, often called a visitation, means spending time in their hospital watching them operate and seeing how their clinic runs. It is a long standing part of how surgical technique spreads. A paper or a conference talk can set out what was done and what followed, but it cannot show the order in which the steps are taken, how the patient is positioned, which instruments are used, or how a particular difficulty is handled at the moment it appears.
Visits of this kind work in both directions. The host explains choices that would otherwise go unstated, and the visitor asks about the parts that differ from their own practice. Over time this is how a technique developed in one centre becomes available in another.
About shoulder replacement surgery
Shoulder replacement means removing the worn surfaces of the joint and replacing them with artificial components. There are two main forms. An anatomic total shoulder replacement reproduces the normal arrangement, with a ball on the upper arm bone and a socket on the shoulder blade, and relies on the rotator cuff tendons being intact. A reverse total shoulder replacement swaps that arrangement, placing the ball on the shoulder blade and the socket on the arm, so that the deltoid muscle can take over the work of lifting when the rotator cuff is torn or no longer functioning.
Which of the two is appropriate depends on the state of the joint surfaces, the condition of the rotator cuff, the shape and bone stock of the socket, the patient's age and what the arm is needed for. Individual results vary.
Related information
See our other 2017 visit posts, including Denver and Memphis, and our anatomic total shoulder replacement, reverse total shoulder replacement and shoulder arthritis pages.