Yesterday was an OR day, and as you all know I really like ortho OR days! I was with the shoulder surgeon and his PA. We had three different kinds of shoulder replacements on the menu for the day. I had never seen any shoulder surgery at all so it was once again a baptism by fire. It turned out that shoulder surgery is one of my all time favorite kinds of ortho surgery. The shoulder anatomy can be difficult to really understand because everything is so packed in and tight. These surgeries really helped me to understand the anatomy and how it all works together. You can't put a tourniquet on for this so its a really bloody surgery and bloody surgeries are my favorite kind. The first replacement we did was called a reverse shoulder replacement. This is a pretty cool operation. They basically put a prosthetic "ball" on the glenoid (the socket part of the shoulder) and then put a "socket" where the humeral head is(the ball part of the shoulder). Hence the term reverse. It's a good procedure for the older person who doesn't need a lot of function but wants pain relief. You can only lift like 10 lbs with it and can only raise your arm to about shoulder height but it gets rid of pain from an arthritic shoulder.

The second operation we did was a hemi shoulder replacement. In this procedure they leave the socket side of the shoulder alone but replace the humeral head with a prosthetic ball. This one gives more function than a reverse but isn't as good at relieving pain symptoms. The guy we did this on was an angus beef farmer so he needed his shoulder!

The third and final operation of the day was a total shoulder replacement. In this one they remove the ball and socket components and replace them with prosthetic parts in the normal anatomic position. Normally this takes about 2 hours to do. It took 3 1/2 yesterday! Our patient was a thick muscular middle aged male with massive deltoid muscles. We were working down in a 5 inch hole. In order to get down in the hole you must retract all of the surrounding tissues and bones. This is absolutely exhausting. It was more tiring and physically demanding than any other joint replacement surgery I have done but I loved every minute of it! I even woke up with sore legs and pecs this morning. I wish I had more time with that doctor.

My time at this rotation site was overall a good experience. I wasn't quite sure how it would go rotating with so many doctors but I ended up liking it. All the doctors were welcoming and liked to teach. It's too bad that the practice is in NEPA or I would be interested in working there. I start my next ortho rotation on Monday and am looking forward to new people, new experiences, and new challenges.