Watch Dr. Shah discuss  ACL Injury, Reconstruction and Return to Sport as a Guest Lecturer for Orthopaedic Principles.   

Early graft ruptures are more prevalent in patients younger than 18 years & Males. Incidence of ACL graft revision was 2.1 times higher with hamstring autograft compared with a BTB autograft.

“Critical Criteria” recommended as part of postoperative Return To Sport  

1. Time since surgery of 8 months  

2. Use of >2 functional tests (single leg hop test greater than 90% of the contralateral side, drop jump, & pivot shift testing)  

3. Psychological readiness to RTP testing 

4. Quad/HS/glut index strength testing ≥90% 

Webinar recorded from 3/4/2022

(c) New England Shoulder and Elbow Center

Watch Dr. Shah discuss  Current Applications of Growth Factors in Knee Arthritis and Cartilage Repair as a Guest Lecturer for Orthopaedic Principles.   

Articular cartilage, devoid of vascularity, relies on diffusion to obtain nutrients and oxygen, thus making intrinsic repair of defects remarkably difficult in vivo.

Growth Factors as Therapeutic Possibilities 

-->Enhance healing of chondral injuries and modify the progression to degenerative arthritis

1. Growth factors and chemotactic cytokines promote the migration of pluripotent mesenchymal stromal cells (MSCs) 

2. Cartilage repair is exclusively mediated by the proliferation and differentiation of mesenchymal cells 

3. Most commonly, marrow substrates including MSCs, growth factors, and cytokines are introduced through marrow stimulation 

Webinar recorded from 8/13/2021

(c) New England Shoulder and Elbow Center

 Shoulder replacement is now routinely performed for patients with moderate to severe shoulder arthritis. It has the potential to relieve pain and improve function for many people. During the procedure, the surgeon removes the arthritic “ball” of the shoulder and smooths down the “socket.” The joint is then replaced with a metal ball, and a polyethylene socket. In reverse shoulder replacements metal balls are placed on the patient’s socket and a plastic cup is placed on top of the humerus. 

Patient has had multiple failed rotator cuff repairs. He also has documented cartilage grade 3/4 changes on the humeral head and glenoid from his previous scope.   

Male with poor range of motion and consistent pain especially at night pre-operatively. A Reverse Shoulder Arthroplasty is preformed for his Cuff Tear Arthropathy.  

Now, the patient is 6 weeks post-operatively with excellent forward elevation and external rotation. He states his pain is much improved as he continues to make progress each day. 

Patient is a 19 y/o Division One football player complaining of left knee pain and swelling in the setting of multiple recurrent patella dislocations. Now he has pain with activities of daily living, mechanical symptoms and subjective instability.  

He has exhausted non-operative management including directed quad strengthening and patella-bearing knee brace.  

MRI images show Tibial Tubercle-Trochlear Groove (TT-TG) distance of 18 mm. Lateral trochlear angle 20. Lateral translation with about 20 degrees of tilt.  

2.5 x 1.5 cm patellar cartilage defect and 1.2 x 1.3 cm trochlear defect. Matrix Assisted Chondrocyte Implantation performed for the patellar defect and Microdrilling with PowerPick XL performed for the trochlear defect.   

Both cartilage procedures were performed with a concomitant tibial tubercle osteotomy as MRI under appreciates the TT-TG measurement compared to CT scan, where the measurement is likely to be over 20. 

Boston and New England's Top Orthopedic surgeons for Shoulder and Elbow Care including: shoulder arthritis and shoulder pain conveniently located in Waltham, Cambridge and Brighton.  

Here at New England Shoulder and Elbow, Dr. Sarav Shah and Dr. Glen Ross treat many athletes and the most common shoulder/elbow injuries in overhead sports like tennis and baseball and many more. These injuries can range from rotator cuff tears to labrum tears and other sports injuries. 

We take care of collegiate sports programs such as Merrimack College and Brandeis University. These injuries can be treated with a variety of methods including physical therapy, injections and potentially surgery. We implement a team based approach focused on getting you back on the field or court as soon as possible. 

62 Male underwent Anatomic Stemless Total Shoulder Arthroplasty. At 3 months, postoperatively he has little pain with excellent range of motion and function. Please talk to your surgeon regarding your specific case. This may not be applicable to every clinical scenario. 

 In this presentation, Dr. Shah discusses the validation of the RAND/UCLA appropriateness criteria for anatomic total shoulder arthroplasty. Using data from 390 patients, the study classified candidates as "appropriate", "inconclusive", or "inappropriate" and examined patient-reported outcomes.  The appropriate group as identified by our Appropriateness Use Criteria had a significantly greater proportion of patients who achieved MCID (95.8%) and SCB (92.6%). 

  67 yo male underwent Primary RSA at an outside institution. Subsequently had pain and dysfunction with concern for infection. After aspiration was negative for growth, I performed an arthroscopic tissue biopsy which confirmed infection. First stage was removal of both components with Glenoid bone grafting and placement of antibiotic spacer. Then second stage was conversion to revision reverse shoulder arthroplasty. Secondary to bone grafting of the glenoid during the first procedure as well as cementing humeral stem, the patient was able to achieve functional range of motion with minimal pain at 3 months postoperatively from the second stage.