Surgeons repair patient’s shoulder in regional first

(CNS Local Life): In what is being called the first surgery of its kind in the Americas, the Health City Cayman Islands (HCCI) orthopedic surgical team, led by Dr Alwin Almeida, repaired the shoulder of Cayman Islands national rugby player Edward Westin, that had dislocated more than 100 times and was so damaged, it would dislocate in his sleep, even after a previous corrective procedure.

Dr Almeida, chief orthopaedic surgeon and joint replacement specialist at HCCI, repaired Westin’s shoulder with a minimally invasive arthroscopic surgery utilising an advanced technique not yet available in the US or Canada, according to an HCCI press release.

The surgery is called an arthroscopic Latarjet, and is the minimally invasive adaptation of a commonly used surgical procedure in orthopaedics and sports medicine. “They do Latarjets in the US, but arthroscopic Latarjet is less common,” Dr Almeida explained. “The technique that we used was a special technique…This is probably the first time it has been done in the region.”

The Latarjet operation, also known as the Latarjet-Bristow procedure, is used to treat recurrent shoulder dislocations, typically caused by bone loss or a fracture of the glenoid. The arthroscopic Latarjet is one of the most difficult surgeries in shoulder arthroscopy and only a few surgeons in the world have the training to perform this technique, said the release.

The Health City orthopaedic team used both surgical implants and techniques pioneered by the UK-based global medical device company Smith & Nephew, which are used throughout Europe.

“It hasn’t been done in the US with that particular implant,” Dr Almeida said. The ‘double button’ technique is not available in the US yet, it’s only going to be launched there next year.

After examining Westin and reviewing his medical records, the doctor decided he was a good candidate for the surgery. Westin had a condition called recurrent dislocation of the shoulder. He’d had surgery on his left shoulder previously, which failed. He was reluctant to try again, but then he met Dr Almeida at a 2017 press conference where Health City announced the hospital’s sponsorship of the Big Game, an annual rugby event in the Cayman Islands.

Westin described the process that led him to the pioneering procedure. “[Dr Almeida] actually goes to the same church as me, and so I explained about my injuries. I have dislocated my shoulders multiple times over the last few years, and he said whenever I have a break in my playing just to get a hold of him and come down to Health City and get them checked out and see what we can do.”

Dr. Almeida said of his patient: “Edward is a special guy, he was one of my most challenging cases so far.”

Ninety percent of the body’s dislocations happen in the shoulder since it’s the most unstable joint in the body, the release said. Once the shoulder is dislocated there is a 40 to 50 percent chance that it can happen again, as in Westin’s case.

Dr. Alwin noted the severity of Westin’s condition: “It got to a point where it would dislocate even in his sleep, and he told me that it had dislocated probably more than 100 times – which is a lot.”

Westin’s main problem was bone loss in the shoulder socket, which made the joint unstable.

Westin said he was confident in the Health City team going in to the surgery, which took place in March this year, and is pleased with the results. He is on the road to recovery and hasn’t ruled out playing rugby again. “That’s the plan right now,” he said. “I still want to get back on the field, but I guess I have to assess after that year of recovery [and] make sure I’m ready for it, first of all.”

For now, Westin is coaching children in the Cayman Islands’ national rugby programme. He added he would recommend Health City to his rugby teammates.

Tags: Dr Alwin Almeida, Health City Cayman Islands, Shoulder surgery

Category: Medical and Health