Shoulder Service

The Shoulder Service, under the direction of Dr. Jon J.P. Warner, has continued to advance care through clinical quality initiatives, research and teaching. This year, Dr. Warner served as the 28th President of the American Shoulder and Elbow Society. This is a premier organization for treatment of this region of the body, and much of his strategic agenda has been implemented through activities and initiatives at the MGH. This has included web-based initiatives in shared decision-making to assist patients in their selection of the best treatment option for their problem. A value-based shoulder care initiative has been ongoing with the Harvard Business School and Michael Porter’s group. This has included “Time-Based Cost Accounting” (TDABC) for shoulder care, and a planned pilot of bundled payments for rotator cuff repair with a local insurer.

Central to the value-based initiatives in shoulder care is outcome measurement and transparent reporting of patient satisfaction, readmission rates, and infection rates, which we post on our website (www.bosshin.com). This year we have begun implementing a novel Internet-based outcomes tool called Surgical Outcomes Study (S.O.S.). This promises to allow us to analyze each patient’s recovery curve compared with his/her peers for the same surgical procedure.

Dr. Luke Oh continues to serve a dual role on the Shoulder (and Elbow) Service and the Sports Medicine Service. His clinical practice has grown and he has started a monthly Elbow Indications Conference for Sports and Shoulder fellows. A collaborative conference with the Upper Extremity Service is being planned as well.

Dr. Thomas Holovacs continues to manage a busy practice and teach the residents and fellows. He has also initiated a translational program in the Biomaterials Laboratory.

The Shoulder Biomechanics Lab, under the leadership of Dr. Daniel Massimini, completed several innovate dynamic anatomy studies. The first of these, which was published in the Journal of Shoulder and Elbow Surgery, analyzed the dynamic anatomy of the suprascapular nerve and provided insight into neurogenic pain with rotator cuff tendon tears. The second study analyzed the dynamic motion of the long thoracic nerve and has provided insight into the etiology of scapular winging.

Daniel continues to work toward completion of his PhD this spring. His studies of 3-Dimensional Kinematics of the normal and abnormal shoulder have given unique insight into the dynamic forces across the glenohumeral joint.

This year four fellows graduated from our postgraduate program. Lewis Shi, MD, took a position at the University of Chicago; Albert Lin, MD, returned home to Pittsburgh to work for Dr. Freddie Fu at the University of Pittsburgh Medical Center; Michael Freehill, MD, took a position in Sports and Shoulder at Wake Forrest and Arnold Alqueza, MD, has remained in Boston to work at the VA Hospital in West Roxbury.

This year’s fellowship match selected four fellows from a competitive applicant pool of over 40 individuals. The fellowship program continues to be one of the most sought-after in the United States.

Finally, we have begun a national search for a Senior Shoulder Surgeon to assist with the clinical and academic load on our ever-growing service.