I would just like to give you an update of some of our recent activities, and tell you a little bit about the general direction we are heading in.

Shoulder Exam

We have done a number of studies to define which clinical tests are useful for diagnosing shoulder problems. Many clinical tests have been found to be redundant and I am pleased to say that the shoulder examination is much easier and quicker to perform. This year at the American Academy of Orthopaedic Surgeries I ran an Instructional Course Lecture with Ed McFarlane and Ben Kibler on Examination of the Shoulder - What's New, What Works and What doesn't. This course had over 700 delegates attend it and was the first instructional courses to sell out. If you would like more information about useful clinical tests, please let me know and I can send you a DVD regarding the shoulder examination.

The quality of our research and education has also been highlighted by the fact the Sports Medicine and Shoulder Fellowship position is now filled through to July 2009 and last year the St George Hospital Orthopaedic Research Institute received its 23rd Award - the NSW Sporting Injuries Committee 2005 FE Johnson Memorial Fellowship for "Outstanding Achievement by an Established Researcher in the Field of Science and Medicine in Sport".

Shoulder Ultrasound

I have now taken the next step in terms of diagnosing shoulder disorders and purchased my own GE logiq 9 ultrasound system and in collaboration with Robyn Tantau, President of the Australian Society of Ultrasound Sonographers, developed a service on focusing on the diagnosis of rotator cuff tears by ultrasound at Premier Orthopaedics. We have developed a new method of reporting shoulder ultrasounds - a sample of which is enclosed. If you would like your patient to have an ultrasound and/or x-ray as part of our service, please request a referral pad for that service or just ask in your referral.

New Day Surgery

Several of us have been fortunate to be involved in the development of a state-of-the-art day surgery in Derby Street, Kogarah. This facility - called "National Day Surgery - Sydney" has three Stryker "i-Suites" with equipment to the value of over $7m. It is the best equipped facility in the world for arthroscopic shoulder surgery. Of course, next month there might be an even better one somewhere else in the world! I have already seen the value of having this equipment on the quality of outcomes for our patients.

Shoulder Replacements as Day Cases

With the advances in technology to see inside shoulders and advances in technology to repair soft tissues arthroscopically, open surgery is becoming increasingly rare. In fact in my practice we are now at the point where all surgery for rotator cuff disorders, instability and stiffness is performed arthroscopically. The only surgery now that is done through an open incision is shoulder replacement. Even there, advances in expertise with regional anaesthesia and patient education have allowed us to do the first total shoulder replacements as day cases in Australia. Shoulder surgery is rapidly becoming like ophthalmology - a few hours in and out of a day surgery - for replacement or repair.