Innovations in Complex Shoulder Reconstruction

In this video, Bassem T. Elhassan, MD, co-chief of the Shoulder Service and program director of the Shoulder Surgery Fellowship at Massachusetts General Hospital, discusses his unique approach to developing tendon transfer procedures in order to alleviate shoulder pain. These innovative shoulder procedures are currently performed exclusively at Mass General, but are also taught as part of the Shoulder Surgery Fellowship curriculum, and therefore shared for use globally.

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Transcript

In patients who have a complex shoulder, elbow and hand problem, specifically after trauma that led to paralysis, we are able, with the help of both anatomic and clinical study, to come up with a number of new innovative procedures that will allow essentially the arm to become much more useful, and it is true mostly through muscle transfer, and in addition occasionally also some joint type of reconstruction and bony reconstruction. The aim of any of these types of procedures is to improve patient outcomes. For patients who for years, they have a problem that was determined to essentially have no solution. Our hope is to give them a solution and we already came up with a good number of innovative procedures that help in this complex problem, and our hope is just to keep on improving them, in order to even optimize more the patient outcome.

Everything in orthopedics requires ongoing research. Any time when we come up with a new procedure, we try to advance our field for that procedure, or those procedures. And definitely any time we come up with a new procedure that we are able to test in the lab biomechanically, anatomically and then clinically, and then we have a good outcome, we make an extra step forward in the field of orthopedics, and we are going to keep on doing that.

Well, any joint in the body requires muscle around it to move it, and if someone has a major injury to that muscle, that is in a way it cannot recover anymore, or you have nerve damage and the muscle becomes paralyzed, then we can try to borrow different muscles that have different type of function to restore a lost function. Most of the time, it is from the same side of the body. Occasionally, we can borrow a muscle from the opposite side of the body to reconstruct the function of the injured side of the body.

In general, the human body is made to have stable and healthy joints and muscles around it to work together to allow you to have painless function. When you have any damage to the bone itself, when you have any damage to the cartilage or the muscle around it, this will create a derangement that will lead to a different level of pain, and we can try to take each of this level and correct it to try to improve the pain as much as possible. Some of these innovative procedures are currently done only here because I came up with these complex reconstructions, and after years and years working on these in the anatomic lab, biomechanics lab and clinically, it was thought to be determined that they really worked very, very well, and we are able to apply them more and we are able to teach them outside of here more. But these procedures are very unique. They are not the standard. Of course, I do all types of procedures of the shoulder, elbow, hand, but these are a higher level of procedure that helps in problems that are really difficult, and currently, because we came up with these innovations, which are done mostly here, and we are hoping to help the patient here, but at the same time, our hope as well is to spread the knowledge around to be able to teach surgeons how to do these complex procedures and hopefully helping patients around the U.S. and the world, here at Mass General.

Learn more about the Shoulder Service at Mass General

Refer a patient to the Department of Orthopaedic Surgery