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  • Applications for the shoulder fellowship starting in 2017 is now open.
    Please apply by visiting the Unit and sending your CV to Jan Barker
    Visits to the Reading shoulder unit are welcome - Please liaise with Jan Barker [Read more]
  • RSU is advertising for shoulder fellowship to start in July 2017
    a post-CCT shoulder fellowship for One year. please send CV to Mrs Jan Barker and arrange a visit to meet Prof Levy and Mr Sforza. [Read more]
  • Coming up courses:

    The Reading Expert Shoulder Course 15-16 April 2019
    Instructional Course

    Smith & Nephew Expert Connect Centre Watford, United Kingdom
    15-16 April 2019
    Course Convener: Prof Ofer Levy (UK)

  • IDO Isometer Shoulder Muscle Strength Gauge.

    Available to buy online in idorth.com - Innovative Design Orthopaedics - [Read more]
  • Shoulder study day for Physiotherapists 26 February 2019 at 18:00 
    at the Royal Berkshire Hoapital.
    Please register your interest by e-mail to: Jonathon.Lee@RoyalBerkshire.NHS.uk [Read more]
  • For GPs - New!!! NHS Choose & Book
    The Unit at Berkshire Independent Hospital is open for NHS patients through Choose & Book (Extended Choice Network).
    Book online
    or contact the secretaries. [Read more]
  • Groundbreaking research from the Reading Shoulder Unit by Prof. Ofer Levy and his team regarding Propionibacterium Acnes and shoulder arthritis. 
    Propionibacterium acnes: an underestimated etiology in the pathogenesis of osteoarthritis?

    This is a very important article in that it suggests the presence of propionibacterium in previously unoperated shoulders with arthritis and furthermore that 'aseptic' failures of shoulder arthroplasty may, in fact, be related to indolent infections with this slow growing organism.
    Read comments by Dr Frederick A. Matsen III, M.D.
    [Read more]
  • New Survey on usage of shoulder replacement prostheses.
    Take the survey [Read more]
  • Listen to the BBC Radio4 programme - a day in the operating theatre at the Reading Shoulder Unit at the Royal Berkshire Hospital - Case Notes with Dr Mark Porter on Regional anaesthesia for shoulder surgery [Read more]
  • The least complications with the Verso shoulder compared with other reverse shoulder systems
    From the Royal National Orthopaedic Hospital, Birmingham, UK

    Bone Joint J 2013 vol. 95-B no. SUPP 27 25

    COMPLICATION RATES FROM THREE
    COMMONLY USED REVERSE POLARITY TOTAL
    SHOULDER REPLACEMENTS: A MINIMUM TWOYEAR
    FOLLOW-UP OF 64 CASES
    S. Robati, M.K. Shahid, J. Allport, A. Ray and G. Sforza 
  • Once again we are running the successful Reading Shoulder Arthroplasty Instructional Course on Friday,  30 September 2016
    • Re-Live surgery
    • Lectures
    • Discussions 
    • Clinical session with patients presentations
    • Hand-on workshop on models
    • Workshop for theatre nurses

    CME Points applied (6 CME Points approved by the BOA for the previous course)

      Register early - limited places

     
    [Read more]
  • The Verso stemless rTSA is approved in Australia & New Zealand by the TGA.
    Its use is launched soon in Australia & New Zealand. 

  • Excellent clinical results over more than 11 years with the Verso rTSA.
    Very high patient satisfaction and return to full activities including sports. [Read more]
  • The Reading Expert Shoulder Course 15-16 April 2019

    Instructional Course
     
    Smith & Nephew Expert Connect Centre Watford, United Kingdom
    15-16 April 2019
     
    Course Convener: Prof Ofer Levy (UK)

    Description

    The Reading Expert Shoulder Course is a two day advanced shoulder course. All the delegates are experienced shoulder surgeons and “All are Faculty”.

    Day One will cover arthroscopic techniques for treatment of complex instability, arthroscopic bone block, arthroscopic Latarjet, and Biceps procedures. Comparison of different methods of rotator cuff repair, various approaches to manage the massive rotator cuff tear, Suprascapular nerve release and more.

    Day Two will cover advances and innovations in total shoulder replacement, especially reverse TSA and stemless rTSA.
    The course will involve lecture-based discussions but is primarily a cadaver lab course with ample opportunity to practice the techniques taught in the Expert Connect Centre.

    Accreditation - Accredited by the Royal College of Surgeons of England.

    Participant profile

    This course is an advanced shoulder course aimed at experienced shoulder surgeons who want to further discuss and develop advanced arthroscopic and arthroplasty skills. Ideal candidates are Shoulder Consultant in first 3-4 years of practice, and even more experienced Consultants.


    Course Faculty


    International Faculty

    Prof Ettore Taverna - OBV Hospital Mendrisio, Switzerland
    Dr Carlos Torrens Canovas - Parc de Salut Mar, Spain
    Dr Juan Bruguera - Unidad de Hombro y Codo, Spain
    Dr Bernd Hinkenjann - St. Agnes Hospital Bocholt, Germany

    UK Faculty

    Mr Jaime Candal Couto - Northumbria Healthcare NHS Trust, UK
    Mr Roger Hackney - Leeds Teaching Hospitals NHS Trust, UK
    Mr Kapil Kumar - Aberdeen Royal Infirmary, UK
    Mr George Arealis – East Kent HUF Trust, UK
    Mr Amar Malhas - Royal Berkshire Hospital, UK
    Ms Julie McBirnie - Royal Infirmary of Edinburgh, UK
    Mr Hannan Mullett - Sports Surgery Clinic Ireland
    Mr Jai Relwani - William Harvey Hospital, UK
    Mr Sunil Sharma - Queen Margaret Hospital, UK
    Mr Giuseppe Sforza - Berkshire Independent Hospital, UK
    Mr Andreas Leonidou - Royal Berkshire Hospital, UK
    And the Reading Shoulder Unit team 

Copeland Shoulder: Results
The results of the Mark 2 design were published in 2001 [19]. 103 shoulders were implanted into 94 patients (9 bilateral). There were 73 females and 21 males. The mean age at the time of surgery was 64.3 years (Range 22-88y). Total shoulder replacement (TSR) was used in 68 cases and Hemiarthroplasty in 35. The average length of follow-up was 6.8 years (Range 5 years to 10 years).


1. Constant Scores


The pre-operative average Constant Score was 15.4 points or 24% after adjustments for age and gender. Post-operative Constant Scores at follow-up was 52.4 points or 75.2% after adjustments for age and gender. Best results were achieved in cases of primary Osteoarthritis with Constant scores of 93.7% for TSR and 73.5% for Hemiarthroplasty. The poorest results were encountered in patients with cuff arthropathy, Instability arthropathy and other causes (arthropathy post septic arthritis) with adjusted Constant Scores of 61.3%, 62.7% and 58.7% respectively. Active elevation improved by an average of 69° to an average of 133° for Osteoarthritis and Aavascular necrosis and to an average of 105° for Rheumatoid Arthritis. For Instability arthropathy and Cuff arthropathy this increased to an average of 97° and 73°, respectively. Pre-operative and post-operative differences were statistically significant for all the disease groups (p<0.001).


2. Patients subjective assessment


93.9% reported that their shoulder was much better or better. 6.1% of  patients  were disappointed and considered themselves to be the same as before surgery, usually because of limited range of motion but they were satisfied with pain relief .


3. Radiological results


There was a 5.1% incidence of progressive lucent lines of more than 2mm, with signs of definite loosening. Since using the hydroxyapatite-coated implants, no lucent lines have been observed. The relevance of the radiolucent line is uncertain, but seems unrelated to the outcome.

In 5 shoulders some degree of mild humeral prosthesis subsidence was found. There seemed to be no effect of the mild subsidence on the clinical result.


4. Complications


    1.   Myositis Ossificans – 0.7%

    2.   Aseptic loosening – 5.1%

    3.   Periprosthetic fracture – 0.7%

    4.   Superficial Infection – 1.4%

    5.   Deep Infection – 0.7%


5. Revision surgery


The revision rate at five to ten years of using the Mark 2 design has been 6%. The indications were:

    1.  Instability following total shoulder resurfacing arthroplasty for instability arthropathy in two patients.

    2.  One periprosthetic fracture following a fall

    3.  One disassociation of the polyethylene glenoid from the metal part of the glenoid component

    4.  One glenoid loosening following a fall

    5.  Two aseptic loosening - One involved both humerus and glenoid, and one glenoid only.
    

Removal of the humeral surface component was easily and speedily done as no cement or prosthetic stem had to be exposed and removed. Removal of cemented stemmed prosthesis is associated with loss of bone stock, perforation and fracture of the humeral shaft.