Too Many Shoulder Replacements? Massachusetts Healthcare Reform Flawed (Orthopedics This Week)
Joseph Abboud, M.D., is an orthopedic surgeon at the Rothman Institute in Philadelphia and associate professor of Orthopaedic Surgery at Thomas Jefferson University Hospital. He tells OTW, “We are seeing a huge increase in the utilization of reverse shoulder replacement. While it is typically done for patients with arthritis and rotator cuff disease, the indications have expanded somewhat. It is interesting to see how much it is being marketed, and in some ways overutilized…and we only have an eight-year track record in the U.S. as far as understanding our salvage options. In particular, it’s not a great option for younger patients; but in some cases it’s being done because it gives so much pain relief and the possibility of return to function. However, the long-term consequences of this is unknown. Patients are in pain and say to the doctor, ‘I’ll do anything to get better function and pain relief.’ The danger is these patients may not fully comprehend the risks. My colleagues at Rothman and I will have some numbers coming out in a year looking at the utilization of standard and reverse shoulder replacement. The issue used to be that the same code had been used for both procedures, so it was hard to decipher which procedure was done. This has now been changed to allow us to track these procedures more accurately. We are hypothesizing that there are more reverse shoulders being done than anyone expects.”