Surgery: useful or not? This is the theme around which the conference was held from June 6 to 8, Nice Shoulder Coursethe annual congress on shoulder surgery, organized by one of the best experts in this very complex surgery, Professor Pascal Boileau (read interview below). He explains the choice of this theme: “Although shoulder surgery has made major progress in recent decades, an operation is never trivial. And, since it is most often a functional surgery – the issue is not to save a life, but to improve comfort, reduce pain, etc. – it is imperative to clearly establish the indications. And, in the case of an operation, to choose validated techniques. Otherwise, the results will not be good, and the patients will be dissatisfied.”
Comments which target professionals but also all those people who, for various reasons, suffer from pain or stiffness in the shoulder and are increasingly likely to consult a surgeon directly, without even having first consulted a rheumatologist or a specialist. sports doctor.
“Forget your shoulder”
To sum up, “Except in the case of trauma or recent injury, surgery is only considered after medical treatments (analgesics, anti-inflammatories) and rehabilitation have failed. It is therefore useless to rush straight to an orthopedic surgeon. As always in medicine, it is essential to make the correct diagnosis, after clinical examination, and if necessary by relying on imaging. A standard X-ray is generally sufficient to confirm a diagnosis of osteoarthritis, for example, or to exclude tendon calcification. An ultrasound scan can possibly help in the diagnosis of tendon injury. On the other hand, systematically prescribing an arthrogram scan or an MRI is not justified.”
His comments about the relevance and the journey in no way oppose the need to treat patients who are often in great pain. “We can understand their request for care: the shoulder joint, contrary to what some people think, is very important. Pain and stiffness in the shoulder can lead to real functional impotence, with people unable to even more to raise their arm, to use their hand; they struggle to brush their hair, to brush their teeth…. The pain spoils their sleep, they wake up exhausted. When surgery is indicated, the results are poor. “very rewarding. The patients are happy, they are returning to a normal life.” And they can “forget their shoulder”, “that’s the point!”
