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A Complex Case Benefits from Collaborative Working

mr rupen dattani and mr peter domos operating in theatre

Mr Peter Domos and Mr Rupen Dattani, shoulder experts at Total Orthopaedics, have recently combined their knowledge and skills to perform a complicated surgery together. For complex cases, surgeons will plan weeks in advance and then work together in theatre to share knowledge and provide guidance throughout the procedure.

A young patient with a complex case

This patient is just 25 years old, a keen rugby player and builder by trade. Following a rugby injury and several further shoulder dislocations, he had lost confidence to use his shoulder for even normal everyday tasks. Not only did this prevent him from playing rugby, but it made his job as a builder difficult and painful. This case was particularly complex as he had already undergone two previous surgeries to try and stabilise his shoulder.

four men playing rugby
An unstable shoulder is more prone to injury in physical sports like rugby

An MRI showed that previous shoulder stabilisation surgery had been unsuccessful, and that he had lost some bone from the front of his shoulder. The scan also indicated there was a lot of scar tissue present, which can cause complications during surgery. Following discussions on the patient’s medical history, injuries and results of the MRI scan, Mr Dattani and Mr Domos recommended a Latarjet procedure to stabilise his shoulder joint. This is where one of the bony prominences on the shoulder blade (Coracoid Process), is transferred to the front of the shoulder joint to help stabilise it.

Following a successful procedure, full recovery and rehabilitation plan post-surgery, the patient is delighted with the results – and he is back playing rugby and working without pain or discomfort.

Collaboration can lead to improved outcomes for the patient

With complex cases such as this, collaboration between surgeons allows for more knowledge to be shared. Mr Domos and Mr Dattani met weeks prior and reviewed the patient’s scans and medical history to plan for surgery accordingly.

As part of the Total Orthopaedics governance structure, our consultants often collaborate on complex cases to maximise our combined expertise. Our patient reported outcomes show that surgeon collaboration for complex cases such as this one, can be beneficial for both the patient and surgeons. 

Mr Rupen Dattani image and biography

Mr Peter Domos

Mr Peter Domos is a double-fellowship trained Consultant Trauma and Orthopaedic Surgeon, specialising in shoulder and elbow surgery. He is an expert in his field, providing a full comprehensive shoulder and elbow service for degenerative disorders, sports injuries and complex trauma. Mr Domos is a keen teacher and trainer of physiotherapists, junior doctors and orthopaedic trainees and is continuously involved in research. He was recently awarded Trainer of the Year 2021 from the University College Hospital London (UCLH) and Middlesex Orthopaedic Society.

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