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  • New, New, New: Innovative Design Orthopaedics -
    IDO Isometer Shoulder Muscle Strength Gauge. [Read more]
  • Interested in the Reading Shoulder fellowship?
    a post-CCT shoulder fellowship for One year. please send CV to Mrs Jan Barker [Read more]
  • Verso Stemless TSA with a new company Innovative Design Orthopaedics (IDO)
  • Coming up courses:
    The "Stephe Copeland" Memorial Reading Shoulde Course 2016, 10th-11th March 2016.

    [Read more]
  • For GPs - New!!! NHS Choose & Book
    The Unit at Berkshire Independent Hospital and Dunedin Hospital is open for NHS patients through Choose & Book (Extended Choice Network).
    Book online
    or contact the secretaries. [Read more]
  • The unit is recognised worldwide, treating patients locally
  • New Survey on usage of shoulder replacement prostheses.
    Take the survey [Read more]
  • Listen to the BBC Radio4 programme - a day in the operating theatre at the Reading Shoulder Unit at the Royal Berkshire Hospital - Case Notes with Dr Mark Porter on Regional anaesthesia for shoulder surgery [Read more]
  • Groundbreaking research from the Reading Shoulder Unit by Prof. Ofer Levy and his team regarding Propionibacterium Acnes and shoulder arthritis. 
    Propionibacterium acnes: an underestimated etiology in the pathogenesis of osteoarthritis?

    This is a very important article in that it suggests the presence of propionibacterium in previously unoperated shoulders with arthritis and furthermore that 'aseptic' failures of shoulder arthroplasty may, in fact, be related to indolent infections with this slow growing organism.
    Read comments by Dr Frederick A. Matsen III, M.D.
    [Read more]
Copeland Shoulder: Results
The results of the Mark 2 design were published in 2001 [19]. 103 shoulders were implanted into 94 patients (9 bilateral). There were 73 females and 21 males. The mean age at the time of surgery was 64.3 years (Range 22-88y). Total shoulder replacement (TSR) was used in 68 cases and Hemiarthroplasty in 35. The average length of follow-up was 6.8 years (Range 5 years to 10 years).

1. Constant Scores

The pre-operative average Constant Score was 15.4 points or 24% after adjustments for age and gender. Post-operative Constant Scores at follow-up was 52.4 points or 75.2% after adjustments for age and gender. Best results were achieved in cases of primary Osteoarthritis with Constant scores of 93.7% for TSR and 73.5% for Hemiarthroplasty. The poorest results were encountered in patients with cuff arthropathy, Instability arthropathy and other causes (arthropathy post septic arthritis) with adjusted Constant Scores of 61.3%, 62.7% and 58.7% respectively. Active elevation improved by an average of 69° to an average of 133° for Osteoarthritis and Aavascular necrosis and to an average of 105° for Rheumatoid Arthritis. For Instability arthropathy and Cuff arthropathy this increased to an average of 97° and 73°, respectively. Pre-operative and post-operative differences were statistically significant for all the disease groups (p<0.001).

2. Patients subjective assessment

93.9% reported that their shoulder was much better or better. 6.1% of  patients  were disappointed and considered themselves to be the same as before surgery, usually because of limited range of motion but they were satisfied with pain relief .

3. Radiological results

There was a 5.1% incidence of progressive lucent lines of more than 2mm, with signs of definite loosening. Since using the hydroxyapatite-coated implants, no lucent lines have been observed. The relevance of the radiolucent line is uncertain, but seems unrelated to the outcome.

In 5 shoulders some degree of mild humeral prosthesis subsidence was found. There seemed to be no effect of the mild subsidence on the clinical result.

4. Complications

    1.   Myositis Ossificans – 0.7%

    2.   Aseptic loosening – 5.1%

    3.   Periprosthetic fracture – 0.7%

    4.   Superficial Infection – 1.4%

    5.   Deep Infection – 0.7%

5. Revision surgery

The revision rate at five to ten years of using the Mark 2 design has been 6%. The indications were:

    1.  Instability following total shoulder resurfacing arthroplasty for instability arthropathy in two patients.

    2.  One periprosthetic fracture following a fall

    3.  One disassociation of the polyethylene glenoid from the metal part of the glenoid component

    4.  One glenoid loosening following a fall

    5.  Two aseptic loosening - One involved both humerus and glenoid, and one glenoid only.

Removal of the humeral surface component was easily and speedily done as no cement or prosthetic stem had to be exposed and removed. Removal of cemented stemmed prosthesis is associated with loss of bone stock, perforation and fracture of the humeral shaft.
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