What Went Wrong: Lessons Learned from 6 Difficult Shoulder Cases

    “It’s fine to celebrate success, but it is more important to heed the lessons of failure.” – Microsoft co-founder Bill Gates

    Even the most sought-after shoulder surgeons don’t get it right the first time with every patient. When they fail, they learn what not to do and then build on that to achieve success with the next patient – and the next, and the next.

    They also share what they’ve learned with other surgeons, as 6 highly experienced surgeon did at ICJR’s 8th Annual Shoulder Course. Moderator Evan S. Lederman, MD, from The Orthopedic Clinic Association in Phoenix, Arizona, led the panel through a discussion on their worst cases and what they learned from them.

    SAVE THE DATE: 9th Annual Shoulder Course, October 15-17 in Las Vegas!

    Below is a brief outline of the patients they described. Click the image above to find out how these cases progressed, how they were managed, and what lessons were learned.

    Percutaneous Fixation of a Proximal Humerus Fracture
    Evan L. Flatow, MD

    • 93-year-old male patient
    • Injured in a fall down the stairs during a syncopal episode
    • Diagnosed with proximal humerus fracture
    • Family wanted the least invasive procedure possible
    • Underwent percutaneous fixation

    Arthroscopic Rotator Cuff Repair
    Kevin D. Plancher, MPH, MD

    • 75-year-old male patient
    • Former semi-professional tennis player
    • Fell down the stairs and landed on his outstretched right hand
    • Immediate pain in his right shoulder; pain with all shoulder movement
    • Unable to work or sleep due to the pain
    • Underwent arthroscopic rotator cuff repair with subpectoral biceps tenodesis to treat a retracted rotator cuff tear

    Reverse Total Shoulder Arthroplasty
    Edward G. McFarland, MD,

    • 61-year-old, right hand-dominant female patient
    • Retired lawyer
    • Osteogenesis imperfecta tarda with a history of multiple fractures
    • Fell while taking out the trash; fracture of the left proximal humerus
    • Treated conservatively at first, but continued to have pain in the shoulder
    • Underwent reverse total shoulder arthroplasty

    Revision of an Infected Anatomic Total Shoulder Arthroplasty
    Gerald R. Williams, MD

    • 68-year-old right hand-dominant female patient
    • Had undergone a right anatomic total shoulder arthroplasty in 2003
    • Presented 12 years later with chills, temperature of 104°F, and drainage from the surgical incision
    • Underwent explantation of the shoulder implant, irrigation and debridement, and placement of an antibiotic hemiarthroplasty spacer
    • Minimally displaced fracture of the humerus noted during surgery

    Reverse Total Shoulder Arthroplasty
    Jon J.P. Warner, MD

    • 53-year-old female patient
    • Injured her right shoulder in a motor vehicle accident 4 years prior to presentation
    • Had undergone multiple surgeries, including open rotator cuff repair
    • Debilitating pain – 6/10 at rest, 10/10 with activity – and poor shoulder function
    • Underwent reverse total shoulder arthroplasty