Elizabeth Hofheinz, M.P.H., M.Ed. • Tue, December 27th, 2016

For many years the standard in training airline pilots has been pre-flight simulators. This helps them become more skilled at flying the actual plane. This is a comfortable thought isn’t it? Exactly! Well, recent developments in shoulder replacement surgery allow surgeons to simulate surgery and this benefits not only the patient, but also the hospital. Jon J.P. Warner, M.D. is chief of the Massachusetts General Hospital Shoulder Service and co-Director of the Boston Shoulder Institute. He and his colleagues are bringing clarity to the operating room via patient-specific planning for shoulder replacement.

Dr. Warner told OTW, “Joint replacement is expensive and the results are unpredictable; and unlike total hip and knee surgery, most orthopedic surgeons have limited experience with shoulder replacement surgery. Since shoulder replacement surgery is performed at a volume of <15% hip or knee replacement surgery, 90% of all shoulder replacements in the U.S. are performed by surgeons who do less than 5 procedures each year. Thus these surgeons may not have enough experience to avoid some common problems. These problems may include incorrect size selection and inaccurate placement of the shoulder replacement components.”

“For shoulder replacement you must select a size that matches the patient’s anatomy, meaning that you have to have a full complement of instruments and implants on hand. To do a single operation the device manufacturer must deliver roughly $75,000 in inventory of instruments and implants; and if the surgeon opens a tray and doesn’t use it then it’s $100 to sterilize it. This economic reality challenges both the hospital and the company to provide cost-effective care.”



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