Rees Group | Surgical Technology, Surgical Learning and Delivery of Orthopaedic Treatments

ORTHOPAEDIC SHOULDER RESEARCH

Shoulder pain and loss of shoulder function are very common in the UK, with 4% of people visiting their GP each year. With more and more patients now referred to hospital specialists for surgical treatments, it is important to know which treatments are suitable and what actions need to be taken for a good and fast recovery.

The Oxford team has been involved for many years in running national surgical shoulder trials and studies in secondary care. Professor Rees is now also working in close collaborations with academic primary care colleagues in the primary care departments of Oxford and Keele to help run large scale national primary care studies in shoulder pain. 

Professor Rees has recently delivered on an awarded a commissioned grant by the NIHR HTA (UK.TASH-D), an epidemiology study investigating the best treatment for first time traumatic shoulder dislocations.

Professor Rees has now authored many number of national shoulder patient treatment pathways to help standardise care in the UK. He has also been leading research into ‘electronic’ collection of patient reported outcome measures (PROMs) in order to improve NHS patient informatics, outcome and decision making for the shoulder patients.

Professor Rees will be focusing on the following areas in the next 5 years:

• Sensor technology for patient rehabilitation – Preventing surgery with enhanced rehabilitation. (Industry collaboration - McLaren Applied Technologies).
• Decision Making and Implant Performance in shoulder replacement surgery – research with the Royal College of Surgeons and National Joint Register.
• 'Big Data' outcome analysis of orthopaedic shoulder procedures
• Innovations in Biomedical 3D Printing – increasing collaboration with Engineering Science.
• Improving shoulder surgery through imaging innovations and minimally invasive surgery – increasing collaboration with Engineering Science and Industry Partners.
• Sensor technology to optimise surgical skills and outcomes. (Industry collaboration - McLaren Applied Technologies).
• Stratifying primary care pathways for shoulder patients (PANDA-S Programme with Keele)

Surgical Skills Research

With most surgical interventions the surgeon is the major factor responsible for patient outcome. The acquisition of surgical skills especially in minimally invasive surgery is a crucially important determinant of patient outcome. The selection of surgeons, skills learning, simulation and competence are all areas that will become more important due to working time restrictions on surgical training. Professor Rees and his group are leaders in this field of research and have set up the Oxford Orthopaedic Simulation and Education Centre (OOSEC). Project themes now include: 

• Improving surgical performance using surgical simulation studies.
• Development of surgical skill assessment tools including a wireless objective assessment device for measuring surgical skills .
• Learning curve studies with protocol and guideline development for learning and training.
• Performance studies based on experience and operative numbers.
• Talent Identification - to aid surgical selection processes
• Transfer validation studies to investigate the true impact on patient outcome of simulation training in orthopaedics. 

Major clinical research projects/trials

Secondary Care

• NIHR HTA funded ‘UKUFF Trial’
• ARUK funded ‘CSAW Trial’
• NIHR funded PARCS Study
• NIHR HTA funded ‘Treatment of first time traumatic anterior shoulder dislocation’ (UK.TASH-D Study)

Community Care

• RCTRCT - Steroid Injection for Shoulder Pain (Early Subacromial Injection Study).
• PANDA-S - Prognostic AND Diagnostic Assessment of Shoulder Pain

Working with patients

We believe in working with patients to develop better care solutions for all.

Professor Rees has led and delivered a James Lind Alliance Priority Setting Partnership to identify the national Top Ten Research Priorities in 'Surgery for Common Shoulder Problems', which involved both patients and clinicians working together. Read it here.

Through collaborations with the Departments of Primary Care and funding from Arthritis Research UK and the Oxford Biomedical Research Unit, we have developed and are assessing Technology Enhanced Patient Information (TEPI) to aid combined decision making with patients.