Why are more and more people having joint replacement? In the hands of an experienced surgeon, both young and older patients can realize gratifying and durable improvement in their quality of life using modern joint replacement techniques.
You specialize in shoulder joint replacement and are drawn to younger patients. Why is this? Most people having shoulder replacements are older and relatively inactive. While I love providing shoulder joint replacements for these individuals so that they can sleep well and perform their activities of daily living, I’m particularly excited about working with those individuals who desire higher levels of activity than those usually recommended for traditional shoulder joint replacement.
How is joint replacement different for young individuals? Younger individuals tend to have more complex forms of arthritis, such as that caused by injury or surgery. This is in contrast to older individuals, who tend to have straightforward osteoarthritis. This is the exciting challenge provided by the young arthritic shoulder: It is more complex to manage, and the shoulder joint replacement has to last longer and has to hold up under heavier use.
Is there a recent development that you’re excited about? At the [University of Washington], we have developed the “ream and run” procedure that avoids the risks and activity limitations associated with the plastic socket replacement used in conventional total shoulder replacement. Instead, we use special reamers to shape the natural bony socket of the shoulder and stimulate healing by early range-of-motion exercises performed by the patient five times per day. We have had the opportunity to offer this procedure to over 500 patients from across the United States, assuring that they understand their critical role in the recovery process.
What new developments do you anticipate in the near future? Our active research is directed at defining the patient, shoulder and procedural characteristics that favor an outstanding result. This information can only come from careful long-term follow-up of each patient to determine her or his individual improvement resulting from the surgery. The more patients that we can include in this long-term research, the more we will learn about the factors that control the outcome.
What do you look forward to? After all these years, I still wake up each day looking forward to my role as a surgeon, an investigator, a teacher and a learner. It is difficult to imagine a life without this fulfilling experience. When not working, you will find me outdoors with my family—hiking, cycling, fishing, birding or just hanging out.
What qualities should a patient look for when choosing a doctor? In my practice of elective shoulder arthritis surgery, I emphasize the word ‘elective’, encouraging patients to elect a surgeon with substantial experience in the procedure of interest to them on the one hand and with whom they can communicate freely on the other hand.