A London surgeon is the first to carry out a new computer guided shoulder replacement procedure in the capital which offers greater accuracy and durability than its predecessors.
Nick Ferran, who introduced AWAKE shoulder surgery to London North West University Healthcare NHS Trust last year, where patients are operated while conscious, says the new procedure is aimed at elderly patients with severe arthritis.
Olive Lovesey, 87, from Wembley, could barely move her left arm before the procedure at Central Middlesex Hospital.
The navigated reverse shoulder replacement procedure took several hours with all surgical planning work plotted beforehand on a computerised 3D model of the grandmother’s shoulder.
Nick, 41, said: “Shoulder replacements are traditionally guided by the surgeon’s eye whereas this technology allows far greater accuracy.”
“The better the accuracy, the better the alignment of the shoulder implant which, in turn means less wear and tear and greater longevity.
“The majority of patients undergoing this procedure will be over 70 so we want to get it right the first time.
“Early shoulder replacements typically lasted 8-12 years compared to 15-20 years for a harder wearing hip or knee replacement. We’re hoping better alignment means we can extend the longevity of shoulder replacements.”
Olive, who used to captain a local bowls team, began suffering from arthritis seven years ago.
She said: “The pain was excruciating and it got to a point where I couldn’t lift my arms much higher than my waist and was losing a lot of strength in my hands.
“I don’t mind admitting I was petrified by the thought of an operation at my age but Nick reassured me everything would be OK. You’ve got to keep going, haven’t you?
The surgical team started the case by attaching a marker to Olive’s shoulder bone, then with markers on their instruments they trace out the bony outline of the shoulder socket all under the watchful eye of an infrared camera and computer. The surgeon can then see an accurate 3D picture of the patient’s bone and the position and direction of their instruments on screen.
This allows them to accurately cut bone, position the implant and insert the screws that hold it in place. The computer guided procedure is reserved for severe cases where longstanding arthritis has worn away the bone, however Nick uses the 3D planning software to ensure all his shoulder replacements are accurately placed.
Nick, who travelled to France with a colleague to initially see how the procedure was carried out, added: “The great thing is that we can see exactly what we are doing and it minimises the chance of us having to operate again if something happens such as a screw being misaligned or the implant having poor fixation in the bone and becoming loose.
So how did it feel being the first surgeon in London to carry out the procedure?
“I have been suing this implant since I became a consultant. It works well for patients and this advance means I can be even more precise with their surgery.
“A lot of prep work goes into it including putting implants into cadavers and working on artificial ‘saw’ bones. My surgical colleagues have shown a lot of interest so we’re looking to increase our capacity during the next year.”
“It’s all about getting the best results for our patients.”
More than 5,000 people have shoulder replacements in the UK every year due to arthritis or other injuries.