
UW Shoulder and Elbow Academy
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This blog by Dr. Frederick Matsen offers Quality information as well as for those concerned with arthritis of the shoulder. Read insight on various procedures, recoveries and more. Dr. Matsen is a Professor in the Department of Orthopaedics at the University of Washington and a shoulder reconstructive surgery and shoulder arthritis specialist.
UW Shoulder and Elbow Academy
2d ago
Acromial stress fractures (ASFs) and scapular spine stress fractures (SSFs) are important complications of reverse total shoulder arthroplasty, limiting patient comfort and function and creating difficult surgical challenges for open reduction and internal fixation.
Acromial stress fractures and scapular spine stress fractures are related primarily to unmodifiable patient risk factors: (1) poor bone density (osteoporosis, female sex, older age, and inflammatory arthritis) and (2) diagnoses of rotator cuff deficiency (cuff tear arthropathy and massive rotator cuff tear). These factor ..read more
UW Shoulder and Elbow Academy
5d ago
Preoperative planning is helpful in anticipating what might be needed to reconstruct an arthritic shoulder; however the final choice of implants is determined at the time of surgery.
A 43 year old man presented with pain and stiffness of his left shoulder. He had a prior CT scan showing an arthritic humeral head centered on a somewhat retroverted glenoid.
We obtained our standard set of plain radiographs: an AP in the plane of the scapula and an axillary "truth" view taken with the arm in a functional arm position of elevation. The truth view showed posterior decentering of the humeral ..read more
UW Shoulder and Elbow Academy
5d ago
Owl you need is love.
Superb owl photo I took during Super Bowl
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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run proc ..read more
UW Shoulder and Elbow Academy
1w ago
One of the most frequently debated topics in shoulder surgery is the choice between reverse total shoulder (RSA, below left) and anatomic total shoulder (aTSA below right) for patients having osteoarthritis with an intact rotator cuff.
This is going to be an upside down post. First the conclusions and then the published evidence from 2024-2025.
Conclusions
(1) Patients having either aTSA or RSA have good reported outcomes. While some papers have reported statistically significant benefits of one or the other, most of these differences are not clinically significant (i.e. the difference ..read more
UW Shoulder and Elbow Academy
2w ago
Stay curious
Anatomic total shoulder arthroplasty - aTSA (rather than reverse total shoulder - RSA) is for many surgeons the "go to" procedure for most patients with cuff-intact shoulder arthritis. While in the past there have been concerns about (1) glenoid component failure and (2) failure of the rotator cuff, modern glenoid implants and improved surgical techniques to assure excellent glenoid component seating along with proper preoperative evaluation of the rotator cuff have greatly reduced these risks. It is well documented that the range of motion is on average better for aTSA than RSA ..read more
UW Shoulder and Elbow Academy
3w ago
An active 34 year old man presented with pain and limited function of his right shoulder and the x-rays shown below.
Because he wished to avoid the risks and limitations of a plastic glenoid component, elected to proceed with a ream and run procedure.
After which he returned to full comfortable function for 13 years.
However at 14 years after his ream and run, he presented with a 9 month history of unexplained pain and stiffness of his shoulder. His x-rays at that time were unremarkable, showing no evidence of glenoid wear, erosion, loosening or adaptive changes.
His ..read more
UW Shoulder and Elbow Academy
3w ago
Most surgery is elective, including operations for shoulder arthritis, rotator cuff problems and dislocation. This gives the patient the opportunity to bring their best, most healthy and most prepared self to the operating room.
Here are some steps we recommend to our patients.
A. Get comfortable with the surgeon, the surgery and the recovery. Discuss with the surgeon
i. what procedure is planned, including the likely benefits to you and the possible risks.
ii. what surgical and non-operative options are there for treating your problem
  ..read more
UW Shoulder and Elbow Academy
1M ago
Back in 1994, four of us published a book entitled Practical Evaluation and Management of the Shoulder, a book that has become a classic. It contains the original descriptions of overstuffing, concavity compression, the Simple Shoulder Test, and the principals shoulder motion, strength, stability and smoothness. It contains printable new patient evaluation and followup forms. It is illustrated by the highly descriptive Steve Lippitt diagrams. In that it is now out of print, many have asked how they might get a copy. I'm pleased to be able to provide a free PDF of the book in its entirety: clic ..read more
UW Shoulder and Elbow Academy
1M ago
I'm thoroughly enjoying and learning lots from
expertly crafted by former fellow and great friend, Tony Romeo.
This is a terrific learning experience for orthopaedic surgeons and PAs of all levels of experience - debutants to masters.
In addition to lots of great times with the Romeos, I had meaningful exchanges with many fellow learners, including Rachel Frank, Chris Ahmad, Julie Bishop, and Michael Amini, past fellows and residents, and other friends. I also had the opportunity to share some of my thoughts on management of shoulder infections, the magic of concavity com ..read more
UW Shoulder and Elbow Academy
1M ago
Stemless humeral components have the advantage of enabling the placement of the humeral articular surface in the desired location independent of the position of a stem in the medullary canal.
As a result, they have become my default for anatomic total shoulder and for the ream and run arthroplasty.
The technique I use is continuing to evolve with experience and from collaboration with my partners, our fellows, our residents, and my colleagues around the world. Below are some elements of my technique as of today. I hope to continue learning.
While this presentation reflect ..read more