Surgery: useful or not? It is around this theme that, from June 6 to 8, was held, 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: “While shoulder surgery has made major progress over the last few decades, an intervention is never trivial. And, since it is a surgery that is most often functional – the challenge is not to save a life, but to improve comfort, reduce pain… – it is imperative to perfectly establish the indications And, in the event of an operation, to choose validated techniques. Otherwise, the results will not be good, and the. dissatisfied patients.”
These remarks target professionals but also all those people who, for various reasons, suffer from pain or stiffness in the shoulder and who are increasingly likely to consult a surgeon directly, without even having first consulted a rheumatologist or a sports doctor.
“Forget your shoulder”
To sum up, “except for trauma and recent lesions, surgery is only considered after medical treatments (analgesics, anti-inflammatories) and rehabilitation have failed. It is therefore useless to immediately run to an orthopedic surgeon. As always in medicine. , it is essential to make the correct diagnosis, after clinical examination, and if necessary relying on imaging. A standard x-ray is generally sufficient to confirm a diagnosis of osteoarthritis, for example, or to exclude tendon calcification. possibly help in the diagnosis of tendon injury. However, systematically prescribing an arthro-CT scan or an MRI is not justified.
His comments about relevance and the journey do not in any way contradict 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 no longer even being able to raise their arm or use their hand; they struggle to brush their hair, brush their teeth, etc. The pain ruins their sleep, and they wake up exhausted. When surgery is indicated, the results are very gratifying. Patients are happy, they return to a normal life.” And they can “forget their shoulder”, “that’s the point!”
