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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:
    we invite you to join us:

    1. Reading Shoulder Arthroplasty Instructional course,  3-4 november 2017. Poznan, Poland.
      With UK and International faculty

      Limited places - Register early
  • 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)
  • Shoulder study day for Physiotherapists
    Will be available soon.
    Please register your interest by e-mail to: course@readingshoulderunit.com [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 
  • Art at the Reading Shoulder and Elbow Centre
    Original fine art prints all dealing with human body in different situations by four artists are exhibited in the Reading Shoulder and Elbow centre 

    The prints on display are available to buy, with the artist contributing a donation to research. For more information please contact the secretaries in the unit.

    [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]
AC Joint Dislocation & Reconstruction

Guidelines for patients following Modified Weaver-Dunn procedure for Reconstruction of the Acromioclavicular joint

Introduction

The Acromioclavicular joint (ACJ) is part of the shoulder complex. It is situated on top of the shoulder joining the clavicle (collar bone) to the scapular (shoulder blade).The joint can be separated (dislocated) as a result of injury. Ligaments are torn and in severe cases surgery is required to stablise the joint.


The operation

The Modified Weaver-Dunn procedure involves utilising sound ligaments (Coraco Acromial Ligament) to reconstruct and stabilise the joint. This reconstruction is supported by an absorbable cord.

The operation can be performed using mini-open surgery through small 5cm incision over the top-front of the shoulder, or through keyhole surgery using 5-6 4mm stab incisions. The surgeon will suggest the most suitable technique for you.

Complications

As with all surgery there is a risk of some complications. These are rare, but you should be aware of them before your operation.

They include:

  • Complications relating to the anaesthetic.
  • Infection.
  • Failure to achieve successful result.
  • A need to redo the surgery.
  • Injury to the nerves or blood vessels around the shoulder.
  • fracture
  • Prolonged stiffness and or pain.
  • Implant failure
  • Re-tear of the ligaments.

If you require further information please discuss with the doctors either in clinic or on admission.

You will usually be in hospital either for a day or overnight. A doctor/physiotherapist will see you prior to discharge and you will be taught exercises to do and given further advice to guide you through your recovery.

GENERAL GUIDELINES

Pain:
A nerve block may be used during the procedure, which means that immediately after the operation the shoulder and arm can feel numb for a few hours. The shoulder will be sore when this wears off and this may last for the first few weeks. It is important that you continue to take the painkillers. Ice packs may also help reduce pain. Wrap frozen peas/crushed ice in a damp, cold towel and place on the shoulder for up to 15 minutes.

Wearing a sling:
You will return from theatre wearing a sling with a body belt. It should be worn under your clothes for three weeks. Only very gentle movements will be allowed under the guidelines of your physiotherapist i.e. for hygiene. After three weeks the body belt will be removed and you will continue to wear the sling over the clothes for a further three weeks. At this time you will start formal physiotherapy.

The wound

  • Open repair: there is an incision of 5cms over the top of the shoulder. The stitch is dissolvable but may require trimming at 3 weeks. Keep the wound dry until it is well healed.
  • Arthroscopic (keyhole) repair: This keyhole operation usually done through five to six 4mm puncture wounds. There will be no stitches; only small sticking plaster strips over the wounds. These should be kept dry until healed. This usually takes 5 to 7 days.

If your wound changes in appearance, weeps fluid, pus, or you feel unwell with a high temperature, contact immediately your GP.

Posture
Before starting any activity/exercise it is important to position your shoulders correctly. This allows normal shoulder function. Gently move your shoulder blades down and in towards the spine but not in a braced back position.

Driving
You will not be able to drive for a minimum of 8 weeks. Your surgeon will confirm when you may begin.

Returning to work
This will depend upon your occupation. You will need to discuss this with your surgeon. Remember you will be completely one-handed for the first 6 weeks and all movements or activities above shoulder level should be avoided for at least 12 weeks from your operation.

Leisure activities
Your physiotherapist and surgeon will advise you when it is safe to resume your leisure activities.

Follow up appointments
You will be asked to make an appointment to be reviewed at The Shoulder Unit approximately three weeks after your procedure. You will be reviewed by your surgeon/specialist physiotherapist who will check your progress.

Progression
This is variable. Following discharge your pain will slowly decrease and you will become more confident. After 6 weeks your physiotherapist will guide you through an appropriate exercise programme to help you regain full function.

Exercises
You will perform only elbow, wrist and hand exercises for the first 3 weeks.Your physiotherapist will teach you the following excursuses.

  1. Keep your arm in the sling and move your hand up and down at the wrist.
  2. With your arm in the sling and the elbow bent at your side, turn the hand to face the ceiling and then the ground.
  3. With arm in the sling regularly shrug shoulders up and down and circle forwards and backwards
  4. In sitting, take your arm out of the sling, bend and straighten the elbow on to your lap.

Repeat each exercise 10 times hourly. Continue these exercises until otherwise

advised by your physiotherapist.

Download a PDF leaflet