Expert: Shoulder Arthritis

The Boise Shoulder Clinic

The Boise Shoulder Clinic serves as a resource for patients with difficult shoulder, elbow, arm or wrist problems, including those with failed prior treatment. The Clinic's mission is to provide excellent patient care, educate patients regarding shoulder and upper extremity disorders and treatments, and contribute to musculoskeletal research.

Scott Humphrey, MD, founded the Boise Shoulder Clinic in September of 2006. He is a board eligible orthopaedic surgeon with specialized training in surgery of the shoulder and upper extremity. Dr. Humphrey grew up in Idaho, and enjoys white-water rafting and skiing.

Procedures that Dr. Humphrey commonly performs include:
- total shoulder replacement
- reverse shoulder replacement
- shoulder arthroscopy
- rotator cuff repair
- shoulder instability repair
- elbow replacement
- elbow instability repair
- endoscopic carpal tunnel release
- fixation of clavicle, shoulder, elbow, forearm, and wrist fractures

How are shoulder problems diagnosed?

When a patient visits the Boise Shoulder Clinic, the diagnosis is generally made using a three-part process:

- medical history - the patient tells the doctor about any injury or other condition that might be causing the pain.

- physical examination - the doctor examines the patient to feel for injury and to discover the limits of movement, location of pain, and extent of joint instability.

- imaging tests - the doctor may order a standard x ray or other type of image, such as an MRI, and arthrogram, or an ultrasound to make a specific diagnosis.

Treatment is tailored to the individual based on several factors, such as the type of shoulder problem, as well as patient age, activity level, and expectations.

Why see a shoulder specialist?

We live in a world of increasing specialization. As more and more new information is discovered in any particular field it becomes harder and harder to maintain a level of expertise without specializing.

The field of orthopaedic surgery is no exception. Though orthopaedic surgery is itself a specialty field, many orthopaedists choose to complete additional training to subspecialize after their general training. Orthopaedic subspecialty fields include musculoskeletal trauma, sports medicine, hand, spine, foot and ankle, and shoulder and elbow. Each of these subspecialty groups produces its own expanding body of knowledge, making it difficult if not impossible for an orthopaedist to stay current in multiple fields.

In addition, specialization has been shown to be beneficial because there is value in repetition for surgeons who perform a particular procedure. Practice is the repetition of an action to improve its quality. The value of practice is recognized in sports, music, and surgery.

According to researchers at the University of Washington, 75% of shoulder replacement surgeries are performed by a surgeon who does only one or two of these procedures per year. They conclude that patients may be better served by a surgeon who sees a large volume of shoulder surgery cases, because the number of times a surgical procedure is performed may have a bearing on how well it is done.

Their findings are supported by researchers for other orthopaedic subspecialties. In an article titled "Association between hospital and surgeon procedure volume and outcomes of total hip replacement in the United States Medicare population," Katz et al provides data supporting the concept that specialists have better outcomes. Specifically, they found that surgeons who performed over 50 hip replacements per year had half the complication rate of those who performed 10 or fewer of these procedures. It is likely that a similar effect may relate to shoulder surgery.

For more information:
C Scott Humphrey, MD
Boise Shoulder Clinic
8756 W Emerald St, Ste 176
Boise, ID 83704
(208) 639-4800
Clinic web site:
www.boiseshoulderclinic.com
Patient education web site:
www.shouldersurgeon.com