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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]
Congenital and developmental disorders

What is Winging of the Scapula?

The shoulder blade is a mobile structure, which is stabilised against the chest wall by a large number of shoulder muscles (Muscles of the shoulder girdleworking in tandem with each other. If this harmonious interaction between one or more of these muscles is disturbed, it can result in the shoulder blade becoming excessively prominent over the back, which is referred to as 'Winging of the Scapula'

The winging may be the result of simple changes in shoulder mechanics as a result of conditions such as impingement or instability or more complex problems such as nerve or muscle dysfunction resulting in poor control and stability of the shoulder blade.

Facioscapulohumeral dystrophy:

This is one of the many conditions that can lead to marked winging of the shoulder blade with significant loss of shoulder function. Facio-scapulo-humeral dystrophy causes muscular weakness of the face, shoulder girdle, and upper arm with selective sparing of the deltoid muscle.  This leads to scapular winging and a marked decrease in flexion and abduction of the shoulder.  As the muscles stabilizing the scapula become involved, the scapula starts to 'wing'. The deltoid is spared, but its action is wasted because of the unstable scapula. The deltoid contracts and the arm attempts to move in a normal fashion, but because the scapula is no longer stable, it wings and rotates under the forces of the long lever arm of the upper limb and scapula complex.

Thoracoscapular Fusion

Mechanical fixation of the shoulder blade to the chest wall provides a stable fulcrum on which the deltoid can exert its powerful action on the humerus and abduct the arm without rotation of the scapula.
Treatment of the patient with muscular dystrophy is best accomplished by a multidisciplinary team from neurology, genetics, psychiatry, orthopaedic surgery, physical and occupational therapy, and medical sociology.  Optimal therapy should be prospective with a thorough approach to total treatment.    The majority of orthopaedic intervention is confined to the rare facioscapulohumeral dystrophy, in which shoulder weakness occurs early and can interfere significantly with upper extremity function. At an early stage, facioscapulohumeral dystrophy affects tasks of repetitive use requiring abduction and flexion of the shoulder, even in such simple daily activities as overhead dressing.

The operation

Mechanical fixation of the shoulder blade to three or four ribs of chest wall is performed using screws and bone graft that is taken from the hip (pelvis)

             

 

Post operatively

following the Thoracoscapular Fusion and for the first 3 months the patient MUST wear a brace (similar to the one pictured below) all the time to support the arm weight and protect the fusion until solid bony healing take place.