Skip to main content
SpringerLink
Log in

Current practice in shoulder pathology: results of a web-based survey among a community of 1,084 orthopedic surgeons

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to report orthopedic surgeons’ management of choice for difficult clinical scenarios of shoulder pathologies.

Methods

A web questionnaire was developed including four clinical scenarios of shoulder pathologies. Subsequently, opinions were solicited from more than 1,000 members of an international association of surgeons specialized in sports traumatology and knee surgery (ESSKA).

Results

The response rate was 40% (412 questionnaires). For scenario 1, first anterior dislocation of the shoulder, the most indicated treatment for 71% of respondents was an arthroscopic Bankart repair (P < 0.001). For scenario 2, shoulder arthritis with concentric erosion and cuff tear, 38% chose a shoulder replacement, while 37% preferred a supraspinatus tendon repair in combination with long head of biceps (LHB) tenodesis or tenotomy. For scenario 3, large tendon tears with 70% fatty infiltration of the infraspinatus tendon and lateral LHB instability, 70% of surgeons considered that, among conservative treatments, hyaluronic acid injection was not an appropriate management. Arthroscopic rotator cuff repair, arthroscopic acromioplasty, and LHB tenotomy gained larger consensus (81, 80, and 79% of respondents, respectively). A double-row technique for rotator cuff repair was preferred to a single-row technique (P = 0.02). Scenario 4, adhesive capsulitis, split the respondents equally, with 51% in favor of a surgical approach and 49% in favor of a conservative approach (N.S.).

Conclusions

On-line questionnaires have the potential to improve knowledge about current trends in clinical practice and can help orthopedic surgeons to develop guidelines.

Level of evidence

Cross-sectional; Level V (expert opinion).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Braithwaite D, Emery J, De Lusignan S, Sutton S (2003) Using the Internet to conduct surveys of health professionals: a valid alternative? Fam Pract 20(5):545–551

    Article  PubMed  Google Scholar 

  2. Brattwall M, Jacobson E, Forssblad M, Jakobsson J (2010) Knee arthroscopy routines and practice. Knee Surg Sports Traumatol Arthrosc 18(12):1656–1660

    Article  PubMed  CAS  Google Scholar 

  3. Calis M, Demir H, Ulker S, Kirnap M, Duygulu F, Calis HT (2006) Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? Rheumatol Int 26(6):536–540

    Article  PubMed  CAS  Google Scholar 

  4. Duquin TR, Buyea C, Bisson LJ (2010) Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. Am J Sports Med 38(4):835–841

    Article  PubMed  Google Scholar 

  5. Eysenbach G, Wyatt J (2002) Using the Internet for surveys and health research. J Med Internet Res 4(2):E13

    Article  PubMed  Google Scholar 

  6. Gaskill TR, Braun S, Millett PJ (2011) The rotator interval: pathology and management. Arthroscopy 27(4):556–567

    Article  PubMed  Google Scholar 

  7. Jacobs LG, Smith MG, Khan SA, Smith K, Joshi M (2009) Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. J Shoulder Elbow Surg 18(3):348–353

    Article  PubMed  Google Scholar 

  8. Jakobsen BW, Johannsen HV, Suder P, Sojbjerg JO (2007) Primary repair versus conservative treatment of first-time traumatic anterior dislocation of the shoulder: a randomized study with 10-year follow-up. Arthroscopy 23(2):118–123

    Article  PubMed  Google Scholar 

  9. Kellerman SE, Herold J (2001) Physician response to surveys. A review of the literature. Am J Prev Med 20(1):61–67

    Article  PubMed  CAS  Google Scholar 

  10. Kirkley A, Werstine R, Ratjek A, Griffin S (2005) Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: long-term evaluation. Arthroscopy 21(1):55–63

    Article  PubMed  Google Scholar 

  11. Koh KH, Ahn JH, Kim SM, Yoo JC (2010) Treatment of biceps tendon lesions in the setting of rotator cuff tears: prospective cohort study of tenotomy versus tenodesis. Am J Sports Med 38(8):1584–1590

    Article  PubMed  Google Scholar 

  12. Leece P, Bhandari M, Sprague S, Swiontkowski MF, Schemitsch EH, Tornetta P, Devereaux PJ, Guyatt GH (2004) Internet versus mailed questionnaires: a controlled comparison (2). J Med Internet Res 6(4):e39

    Article  PubMed  Google Scholar 

  13. Masters K (2008) For what purpose and reasons do doctors use the Internet: a systematic review. Int J Med Inform 77(1):4–16

    Article  PubMed  Google Scholar 

  14. Moosmayer S, Lund G, Seljom U, Svege I, Hennig T, Tariq R, Smith HJ (2010) Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: A randomised controlled study of 103 patients with one-year follow-up. J Bone Joint Surg Br 92(1):83–91

    Article  PubMed  CAS  Google Scholar 

  15. Muller-Rath R, Ingenhoven E, Mumme T, Schumacher M, Miltner O (2010) Perioperative management in outpatient arthroscopy of the knee joint. Z Orthop Unfall 148(3):282–287

    Article  PubMed  CAS  Google Scholar 

  16. Paterson WH, Throckmorton TW, Koester M, Azar FM, Kuhn JE (2010) Position and duration of immobilization after primary anterior shoulder dislocation: a systematic review and meta-analysis of the literature. J Bone Joint Surg Am 92(18):2924–2933

    Article  PubMed  Google Scholar 

  17. Radnay CS, Setter KJ, Chambers L, Levine WN, Bigliani LU, Ahmad CS (2007) Total shoulder replacement compared with humeral head replacement for the treatment of primary glenohumeral osteoarthritis: a systematic review. J Shoulder Elbow Surg 16(4):396–402

    Article  PubMed  Google Scholar 

  18. Redfern J, Burks R (2009) 2009 survey results: surgeon practice patterns regarding arthroscopic surgery. Arthroscopy 25(12):1447–1452

    Article  PubMed  Google Scholar 

  19. Robinson CM, Jenkins PJ, White TO, Ker A, Will E (2008) Primary arthroscopic stabilization for a first-time anterior dislocation of the shoulder A randomized, double-blind trial. J Bone Joint Surg Am 90(4):708–721

    Article  PubMed  Google Scholar 

  20. Saridakis P, Jones G (2010) Outcomes of single-row and double-row arthroscopic rotator cuff repair: a systematic review. J Bone Joint Surg Am 92(3):732–742

    Article  PubMed  Google Scholar 

  21. Seida JC, LeBlanc C, Schouten JR, Mousavi SS, Hartling L, Vandermeer B, Tjosvold L, Sheps DM (2010) Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med 153(4):246–255

    PubMed  Google Scholar 

  22. Wu W, Weaver D (1997) On-line democracy or on-line demagoguery? Public opinion “polls”on the internet. Harvard International Journal of Press/Politics 2(4):71–86

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento Di Scienze Medico-Chirurgiche, Università Degli Studi Di Milano, IRCCS, Policlinico San Donato, Milan, Italy

    P. Randelli, P. Arrigoni, F. Cabitza, V. Ragone & P. Cabitza

  2. Dipartimento di Informatica Sistemistica e Comunicazione, Università degli Studi di Milano-Bicocca, Milan, Italy

    F. Cabitza

Authors
  1. P. Randelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Arrigoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Cabitza
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Ragone
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Cabitza
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Randelli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Randelli, P., Arrigoni, P., Cabitza, F. et al. Current practice in shoulder pathology: results of a web-based survey among a community of 1,084 orthopedic surgeons. Knee Surg Sports Traumatol Arthrosc 20, 803–815 (2012). https://doi.org/10.1007/s00167-011-1673-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-011-1673-z

Keywords

Search

Navigation