Quality of Care

Advancing the state of rotator cuff treatment at Lexington Clinic’s Shoulder Symposium

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The 16th Annual Shoulder Symposium, hosted by the Shoulder Center of Kentucky at Lexington Clinic, July 26–27, will take on the question “The Rotator Cuff: What are we really treating?” For Ben Kibler, MD, founder of the Lexington Clinic Orthopedics – Sports Medicine Center, this means helping physicians and physical therapists better understand shoulder biomechanics and pathophysiology, so they can provide the highest quality surgical and therapeutic care. “Recent studies suggest the types of treatment for rotator cuff injuries vary quite a bit, and there is a lot of new information. We want to try to focus the symposium attendees’ thoughts on best practices,” Kibler says. To that end, the symposium will cover the basics of rotator cuff injury, evaluation and treatment options, and the foundations and applications for rotator cuff rehabilitation.

The rotator cuff consists of four muscles and their tendons that serve to stabilize the top of the humerus against the shallow socket of the scapula. The breadth of pathology possible in the complex is considerable. Collectively referred to as rotator cuff disease, its causes and the ramifications for long term shoulder health are numerous. While many people with rotator cuff disease experience no pain, others find the pain and dysfunction intolerable. Chances are there is more rotator cuff disease present than is being diagnosed, and the significance of ignoring such pathology is unknown. For Kibler, the symposium topic is relevant because, “We are trying to figure out how to address the different types of rotator cuff tears. Our primary focus is determining which ones need surgery and which ones can improve with therapy alone.”

Differentiating between surgical and non-surgical pathology is a primary focus of the Shoulder Symposium this year. Consensus among orthopedic surgeons is that there has been a tendency to over-treat rotator cuff disease, so there is a growing desire to utilize non-surgical options first. For chronic tears, physical therapy or other non-surgical treatment modalities may be satisfactory in many patients. Nationally recognized physical therapists will join the Lexington Clinic physical therapy staff at the Shoulder Symposium to ensure that attendees will receive the most current information on rotator cuff physical therapy. According to Kibler, a recent development is that “you have to work on the shoulder blade as the base of rotator cuff exercises, rather than the arm. Therapeutic retraining of the muscles to hold the ball and the socket is emerging as a viable solution in these cases.” Surgery remains inevitable in many cases. For more acute or massive tears, surgery may be needed more quickly. New surgical techniques and options will also be presented at the 2013 Shoulder Symposium.

The symposium will include lectures, didactic sessions, panel discussions, video case presentations, and hands-on rehabilitation workshops, and some of the leading practitioners on rotator cuff disease are on the symposium faculty. Kibler will present on retraining surrounding muscles following traumatic rotator cuff injury and his partner, Trevor Wilkes, MD, will discuss new diagnostic techniques. Guest lecturers include John Kuhn, MD, chief of shoulder surgery at Vanderbilt University; William Mallon, MD, editor-in-chief for the “Journal of Shoulder and Elbow Surgery” from Triangle Orthopedic Associates; Michael Schaffer, PT, ATC, clinical supervisor for sports rehabilitation at the University of Iowa; and Brian Leggin, DPT, ATC, of the University of Pennsylvania Presbyterian Medical Center.

Kibler is proud of this annual event because “It considers the most current, state-of-the-art thinking in the field.” Orthopedists and physical therapists from across the country are expected to gather in Lexington for the Symposium, with attendance projected to reach 200 people. For more information or to register, go to http://www.lexington-clinic.com/shoulder/scseminars.html.