Mr  Iossifidis    MD, FRCS Ed,  FRCS Ed  (orth.)

                 

             Consultant   Shoulder &  Elbow  Surgeon

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One-stop diagnostic clinic and treatment of shoulder pain

Emailexpert@shouldersolution.com

 

© 2015 -  The Shoulder clinic

Total daycare shoulder surgery


Shoulder & Elbow :   Volume 1 ,  Issue 1 , Pages 25 - 28,  June 2009

 Journal Compilation © 2010 British Elbow and Shoulder Society


http://sel.sagepub.com/content/1/1/25.abstract



Background 

There is continued interest in day surgery. Arthroscopic shoulder surgery may be performed on a daycase basis. Historically, daycase shoulder surgery has been limited by peri-operative pain and anaesthetic issues; and to date there are no reports of daycase shoulder arthoplasty in the literature.

Methods 

A prospective study of 112 patients having shoulder therapeutic arthroscopy or arthroplasty managed according to the total daycare pathway, which includes balanced anaesthesia and simple analgesia.

Results

 One hundred and eight patients (96%) were discharged home by 17.00 hours without complications. However the remaining five cases required overnight admission for medical or anaesthetic reasons.

Conclusion 

This study demonstrates that, with the correct infrastructure and a multidisciplinary approach: the full spectrum of shoulder surgery may be performed on a daycase basis using interscalene block and simple analgesia.

 


OTHER   PUBLICATIONS


Diagnostic accuracy of surgeon and radiologist performed ultrasound scan and MRI 

in the detection of rotator cuff tears requiring repair.

Shoulder and Elbow 2012, 4, 308

The triad of essential lesions of the capsular-labral complex in shoulder dislocation.

EFORT European Federation of national associations of orthopaedics and Traumatology.

Bone &Joint  , Sept 2012, 94-B, 570.

 

Development and Validation of a shoulder self-assessment questionnaire

 British Elbow and Shoulder Society. Oxford, St Catherine’s College,  March  2010

Shoulder & Elbow 2010 2, pp 217–230

 

 

Results of arthroscopic rotator cuff repair.

EFORT - EUROPEAN FEDERATION OF NATIONAL ASSOCIATIONS

OF ORTHOPAEDICS AND TRAUMATOLOGY:
J Bone Joint Surg Br Proceedings, Mar 2009; 91-B: 123.

 

 

Arthroscopic rotator cuff repair mid-term (102 cases)

BESS   British Elbow and Shoulder Society,Telford , June 2007

J Bone Joint Surg Br Proceedings, May 2009; 91-B: 258.

 

 

Accuracy of  magnetic resonance arthrography when compared to

arthroscopic findings in shoulder instability.

BESS   British Elbow and Shoulder Society,  Cambridge, July 2005

J Bone Joint Surg Br Proceedings, Jul 2008; 90-B: 213.

 

Inter-scalene nerve block in day-case shoulder surgery

 BESS   British Elbow and Shoulder Society,  Cambridge, July 2005

J Bone Joint Surg Br Proceedings, Jul 2008; 90-B: 215.

 

 

Day Case Shoulder Surgery: is it safe and well tolerated

Journal of one day surgery 2007,vol17;supp,pages A2

 

 

 

Inter-scalene nerve block in day-case shoulder surgery

European Journal of Surgical Traumatology,  2006

 

 

Shoulder surgery using balanced  general and interscalene anaesthesia.

Greek Orthopaedic Association
J Bone Joint Surg Br Proceedings, Jul 2004; 86-B: 175.

 

 

Results of arthroscopic minimal excision of the AC Joint

Greek Orthopaedic Association
J Bone Joint Surg Br Proceedings, Jul 2004; 86-B: 174.


 

Arthroscopic subacromial decompression. Outcome evaluation with

a self assessment questionnaire.

Greek Orthopaedic Association
J Bone Joint Surg Br Proceedings, Jul 2004; 86-B: 171.


Results of arthroscopic minimal excision of the AC Joint

BRITISH ELBOW AND SHOULDER SOCIETY:
J Bone Joint Surg Br Proceedings, Jul 2002; 84-B: 194.

 

Interscalene brachial plexus blockade: implication for the elderly.

British Journal of Hospital Medicine.  62(8) 506-508, 2001

 

 

Function of the coraco-humeral ligament and its role in impingement

BESS   Reading, Sept 1995. Iossifidis.  M.Watson,  Guy’s Hospital, London    

J Bone Joint Surg. 78 B,supp I , 30, 1996

 

 

Arthrocopic Fixation of Greater Tuberosity Fractures: a new technique

Injury Extra, Volume 36, Issue 10, October 2005, Pages 413-415

 

 

Necrotising fascitis of the shoulder following muscle strain.

International Journal of Clinical Practice (60,7, 856-857),  July 2006

 

A rare case of progressive and late onset posterior interosseous nerve palsy

following distal biceps tendon repair.
Injury Extra,  37,244-24,   2006

 

 

Isolated first rib fracture in a child.

European Journal of Surgical Traumatology  .2006

 

Tendon interposition in boxer’s fracture, an unusual cause of non-union and extensor dysfunction of the little finger .
Injury Extra, Volume 36, Issue 7, July 2005, Pages 237-238

 

 

Post traumatic Duplication of the clavicle.

Injury Extra, Volume 36, Issue 9, September 2005, Pages 389-391

 

Rapid nerve recovery following decompression : post traumatic  AXONAMONOSIS.

International Journal of Clinical Practice  2004, Jan,58(1):96

 

 

Macrodactyly; an unusual cause of carpal tunnel syndrome

Calicut Medical Journal    2004; 2 (3): e5

 

 

Anatomy and clinical relevance of a large posterior branch of the Radial nerve 

in  the arm

British Orthopaedic Research Society , Sept.1996, Brighton

J Bone Joint Surg. 79 B,supp II , 362, 1997

 

 

Knee Arthroscopy under Local Anaesthesia : results and evaluation of patient  satisfaction.

InjuryVol 27 : 43, 1996

 

 

Mechanoreceptors within the Human Anterior Cruciate Ligament.

Iossifidis.A.,Heatley FW,   Rayne Institute, St Thomas’  Hospital, London

London British Orthopaedic Research Society, March 1995.

J Bone Joint Surg. 78 B,supp I , 35, 1996

 

 

Painful Bipartite Patella in adults following trauma.

Injury , Vol. 26; 3 :175, 1995

 

Extra-articular synovial chondromatosis of the ankle.

J Bone Joint Surg 77B: 659,1995

 

 

Bone scintigraphy in painful bipartite patella.

European Journal of Nuclear Medicine, 22: 1212, 1995.

 

 

Synovial Chondromatosis of the ankle. 

The FOOT , vol 5;  1: 44, 1995

 

 

Aneurysm of the superficial palmar arch, mimicking acarpal tunnel syndrome.    

International Orthopaedics,   SICOT ,  19: 403, 1995

 

 

PRESENTATIONS -  National  & I nternational societies



 

Guest lecture :

Hemiarthroplasty  for complex humeral head fractures ; Indications and techniques

Greek Shoulder Orthopaedic Association.       Athens, Oct 2013

 

Diagnostic accuracy of surgeon and radiologist performed ultrasound scan and MRI in the detection of rotator cuff tears requiring repair.

European surgical society of Shoulder and Elbow surgery ESSSE, Istanbul, June 2013


Ultrasound for the detection of full thickness rotator cuff tears :
the learning curve for an orthopaedic surgeon via a novel training method.

British Elbow and Shoulder Society  June 2012 .


Diagnostic accuracy of surgeon and radiologist performed ultrasound scan and MRI in the detection of rotator cuff tears requiring repair.

British Elbow and Shoulder Society,  June 2012.


Results of double row Suture bridge arthroscopic rotator cuff repair, and factors affecting the outcome. (poster) 

European surgical society of Shoulder and Elbow surgery ESSSE   Dubrovnic Sept 2012


Accuracy of rotator cuff tear detection by surgeon performed ultrasound scan compared to MRI and radiologist performed ultrasound scan. (poster) 

European surgical society of Shoulder and Elbow surgery ESSSE   Dubrovnic Sept 2012


Ultrasound for the detection of full thickness rotator cuff tears : thre learning curve for an orthopaedic surgeon. (poster) 

European surgical society of Shoulder and Elbow surgery ESSSE   Dubrovnic Sept 2012


Guest lecture :

Arthroscopic management of large rotator cuff tears.

Greek Shoulder Orthopaedic Association.       Athens, Oct 2012

 

 

 Shoulder assessment score : validation of a patient based questionnaire for rotator cuff disorders. 

European surgical society of Shoulder and Elbow surgery ESSSE   Lyon, France, Sept 2011

 

 

Results of a single row arthroscopic rotator cuff repair and factors influencing the surgical outcome. (poster)   

European surgical society of Shoulder and Elbow surgery ESSSE   Lyon, France, Sept 2011

 

Accuracy of  Ultrasound scan detection of rotator cuff tears performed by a shoulder surgeon

Greek Shoulder Orthopaedic Association. ,Athens, Oct 2011

 

 

Outcome of arthroscopic rotator cuff repair in patients aged over 65.

Greek Shoulder Orthopaedic Association.       Athens, Oct 2011

 

 

Guest lecture :

 

Outcome assessment after shoulder surgery..

Greek Shoulder Orthopaedic Association.       Athens, Oct 2011

 

 

The triad of essential lesions of the capsulolabral complex in shoulder dislocation.

European Federation of national associations of orthopaedics and Traumatology 

EFORT.  Copehagen June 2011

 

A  new shoulder questionnaire for evaluating patients with rotator cuff disorders. (poster) 

European Federation of national associations of orthopaedics and Traumatology 

EFORT.  Copehagen June 2011

 

Development and Validation of a shoulder self-assessment questionnaire

British  Elbow and Shoulder Society, BESS.  Oxford ,  St’ Catherine’s college,  March 2010,

2010 British Elbow and Shoulder Society. Shoulder & Elbow 2010 2, pp 217–230

 

Arthroscopic evaluation of the anterior capsule-labral complex in shoulder dislocation: the Triad of essential Lesions 

Greek Orthopaedic association.  Athens, Oct 2010

 

 

Results of single row arthroscopic rotator cuff repair and factors influencing the surgical outcome 

Greek Orthopaedic association.  Athens, Oct 2010

Ultrasound for the detection of full-thickness rotator cuff tears: 

the learning curve for an orthopaedic surgeon using a novel training method



Shoulder & Elbow 

 first published on October 30, 2014   as doi:10.1177/1758573214557146

 

http://sel.sagepub.com/content/early/2014/10/30/1758573214557146.abstract


 

Background 

The study aims to add to the body of evidence delineating the learning curve for a shoulder surgeon to become proficient in focussed ultrasound for the detection of full-thickness rotator cuff tears, as well as to describe a learning method for this skill.


Results 

Two hundred and ten shoulders were scanned over three equal learning periods. Comparing predictive values from the first to the third training period, sensitivity improved from 0.86 to 0.95, specificity from 0.92 to 0.98, negative predictive value from 0.94 to 0.98, and positive predictive value from 0.82 to 0.95.


Conclusions 

The high predictive values obtained in the present study for surgeon-led detection of cuff tears using ultrasound are comparable with those quoted for musculoskeletal radiologists in the literature. The present study adds evidence that a shoulder surgeon can achieve accelerated learning of this skill and offers some potentially time-saving and patient-friendly alternatives to existing guidelines.