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QC Objective 3: Offer the full complement of non-surgical and surgical care

Our consultants are highly trained surgeons who each performs between 20 - 30 shoulder and upper limb surgeries a month. They fully recognize,
however, that the field of Orthopedics encompasses much more than surgery. Orthopedic research is constantly finding non-surgical alternatives,
either to forestall or to entirely prevent surgery. For instance, a recent study found that almost 75% of patients experiencing shoulder pain
5
from calcific tendonitis—calcium buildup in the rotator cuff tendon—were completely symptom-free six months after needle aspiration treatment.
Aspiration treatment is one of the non-surgical treatment modalities offered at SUL. Depending on the patient’s history, non-surgical solutions can
provide great alternatives to surgical intervention or at the very least delay the need for surgery.

Therefore, exhausting conservative treatment options before considering surgery is an important quality
component of any Orthopedic practice. Putting quality first, SUL educates our patients on all treatment
options, whether SUL offers them or not. When needed, we refer our patients to other quality providers.
Some of the non-surgical treatments SUL offers include:

• NSAIDs
• Topical painkillers
• Exercise
• Proper use thermotherapy, cryotherapy and other treatment modalities
• Orthotics and bracing
• Corticosteroid injections & needle aspirations
• Physiotherapy

Physiotherapy is a very important part of SUL’s treatment alternatives. In fact, over 60% of our interventions
are for physiotherapy care. The Unit has hired and trained senior physiotherapists who specialize in the
shoulder and upper limb.

Under the guidance of the medical team, the physiotherapy team has developed comprehensive patient
guidelines for upper limb physical therapy and work closely with the Unit’s physicians to ensure that patients
are improving.

Physiotherapists also have extensive educational materials and illustrations on hand for patients to supplement
their care and rehabilitation from home.

5 Bart W. Oodelar, et. al., “Needle aspiration of calcific deposits (NACD) for calcific tendinitis is safe and effective: Six months follow-up of clinical results and complications in a series of 431
patients”, European Journal of Radiology, April 2016, V85, Iss.4, pp. 689-694.
The Shoulder and Upper Limb Unit