misc Q's re: fellowships, SLAP repair

[reddirtgirl]

How common is it for people in ortho to do fellowships?
Is it like some surgical subspecialties where people to multiple fellowships?

How common is a SLAP lesion repair procedure?
How does one best determine if they have the right guy for the job?
If contrast MRI is known to miss this diagnosis, and arthoscopy is the gold standard for making the diagnosis, how likely would a surgeon go straight from PE to surgery w/o doing the MRI?

Thanks!

in case anyone's interested, here's some animated presentations on the topic:
http://www.shoulderdoc.co.uk/education/SLAP_Climbers/player.html
http://www.shoulderdoc.co.uk/education/SLAP_Repair/player.html

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[Tired]

Just so you know where my answers are coming from. I am an MSIV matched to a military Ortho program. I did 3 Ortho Sub-i's this year, and had assorted clinical experiences with Ortho throughout my med school career. There are probably better people to answer your questions, but the Ortho residents don't seem to cruise this forum all that often anymore, so I'll give you my best answers.

How common is it for people in ortho to do fellowships?

Becoming more and more common, approaching the point where it is mandatory. All Ortho fellowships I am aware of are only one year long, making it relatively easy to do.

Is it like some surgical subspecialties where people to multiple fellowships?

I've met several Orthopods with two fellowships under their belt. I'm not aware of the numbers.

How common is a SLAP lesion repair procedure?

Very.

How does one best determine if they have the right guy for the job?

If contrast MRI is known to miss this diagnosis, and arthoscopy is the gold standard for making the diagnosis, how likely would a surgeon go straight from PE to surgery w/o doing the MRI?

You're now in the realm of medical advice, which we don't give out on SDN.

Good luck.

 

[SOUNDMAN]

SLAP can be missed on an MRI with arthrogram, especially if it's only a partial tear. However PE is critical as well to the diagnosis. If your PE and mechanism of injury are consistent with a SLAP and a person is not getting better say after conservative treatment, then yes arthroscopy is considered the gold standard for diagnosis.

A sport medicine fellowship trained ortho or shoulder specialist will have done many of these. It's a little less common than rotator cuff repair, and I know some surgeons that don't do any labral work at all.