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  • Applications for the shoulder fellowship starting immediately in 2015 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 ASAP
    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:
    we invite you to join us:

    1. Reading Shoulder Arthroplasty Instructional course,  11 December 2015
      With UK and International faculty

      Limited places - Register early
    2. The “Stephen Copeland Memorial” Reading Shoulder Course - 10-11 March 2016
      on Challenges and Revisions in Shoulder Surgery - with Live surgery

      With prestigeous International Faculty
      Limited places - Register early
    [Read more]
  • New, New, New: Innovative Design Orthopaedics -
    IDO Isometer Shoulder Muscle Strength Gauge. [Read more]
  • Verso Stemless TSA with a new company Innovative Design Orthopaedics (IDO)
  • Physiotherapists interested in shoulder surgery are invited to the "Stephen Copeland Memorial" Reading Shoulder course, 10-11- March 2016, with outstanding international faculty. [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]

    Bone Joint J 2013 vol. 95-B no. SUPP 27 25
    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,  11 December 2015
    • 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]
  • Sad news   11 April 2015

    It is with great sadness that I inform you of the passing of our good friend, teacher and esteemed colleague, Stephen Copeland.  
    Steve passed away yesterday in his home in Henley-on Thames, after fighting bravely in the last 18 months with the remission of lymphoma. 
    It is a very sad loss to us all and he will be greatly missed by his family, friends, colleagues, and anyone that knew him throughout the world. 
    Steve was a true leader in shoulder surgery, known worldwide for his unique and innovative approach to shoulder surgery, as one of the pioneers in shoulder arthroscopy, and the “father” of shoulder resurfacing and stemless arthroplasty. 
    He was a founding member of the British Elbow and Shoulder Society (BESS), one of the first members of the European Shoulder and Elbow Society (SECEC) and its president (1999-2001), the first international corresponding member of the American Shoulder and Elbow Society (ASES) and president of the International Congress for Surgery of the Shoulder and Elbow (ICSES).
    He was a masterful teacher, excellent surgeon, great friend and caring family man. Above all, he was a true gentleman and a humble man.
    Steve will be missed by all, and he is on our prayers.
  • Reading Shoulder Arthroplasty Course 11 December 2015
    Re-Live surgery
    Clinical session with patients presentations 
    Hands-on workshop on models
    International faculty
    Invited guest speaker: Prof. Ralph Hertel

    [Read more]
Propionibacterium acnes: an underestimated etiology in the pathogenesis of osteoarthritis?


Background: Propionibacterium acnes is a common pathogen in infections after shoulder surgery. Recent reports found positive Pacnes cultures in a high percentage of patients who had revision shoulder arthroplasty for ‘‘aseptic loosening’’ without any overt signs of infection. Isolation of P acnes is difficult, and by use of conventional microbiological protocols of 48-hour incubation, a considerable proportion of patients with possible P acnes infection may remain unidentified. 

We recently noted P acnes in shoulder joint cultures in patients undergoing primary shoulder replacement for glenohumeral arthropathy without any signs of infection.

Methods: We collected aspirates and biopsy specimens from 55 consecutive patients with arthritic shoulders undergoing primary joint replacement and examined them for the presence of P acnes. Special measures were taken to ensure that the specimens were carefully taken from within the joint to reduce the risk of contamination to minimal.

Results: In 23 of 55 consecutive patients (41.8%) undergoing primary shoulder joint replacement, P acnes was found in the joint fluid and tissues taken before the insertion of the implants. All these patients were treated early postoperatively with pathogen-directed specific dual oral antibiotic treatment for 4 weeks. In none have any signs of infection developed.

Discussion and conclusion: This finding of a high incidence of P acnes in joints before arthroplasty may suggest a role of P acnes in the pathogenesis of glenohumeral arthropathy. In addition, it raises the question of whether development of painful joint replacement later on and presumed aseptic loosening do, in fact, comprise an unrecognized low-grade infection that has been present since before the index operation. 

Level of evidence: Level IV, Case Series, Prognosis Study.

2013 Journal of Shoulder and Elbow Surgery Board of Trustees.

Keywords: Propionibacterium acnes; P acnes; infection; osteoarthritis; glenohumeral arthropathy; primary

shoulder arthroplasty; aseptic loosening; joint replacement

(J Shoulder Elbow Surg (2013) 22, 505-511)