JUNE 2020 • Volume 13, No. 6

From the Editor

As hospitals work to address the backlog of elective surgeries postponed due to COVID-19, we take a look at shoulder surgeries.

About 53,000 people in the U.S. have shoulder replacement surgery every year, according to the American Academy of Orthopaedic Surgeons (AAOS).  (That’s in a normal year, of course—not 2020.) The number has soared in the past two decades due to improvements in technology and Baby Boomers hitting their 60s and 70s. Besides replacement, there are many other kinds of shoulder surgeries. They range from arthroscopic debridements and decompression to labral repair/shoulder stabilization, rotator cuff repair and acromioclavicular joint repairs. Scroll down for some news and videos on the topic.

Our Student in the Spotlight is Amy Purkey, FNP, of Keizer, OR.

Read on for an all-new crossword puzzle, jobs we’ve assembled for you, and NIFA’s favorite links.

Enjoy, and take care.

Julie Lancaster, Editor

Photo above (doc and shoulder patient): Shutterstock

Shoulder Surgery


Here’s a summary of eight of the more common types of shoulder surgery. They are procedures to address impingement syndrome, SLAP (Superior Labrum Anterior and Posterior) tears, shoulder dislocation, frozen shoulder, rotator cuff damage, Acromioclavicular (AC) joint damage, biceps tendon problems, and of course, shoulder replacement. Read more . . .

Arthroscopic Surgery

“Arthroscopic surgery has arguably been the biggest orthopaedic advancement in the last century,” begins this article by Lennard Funk, Asia Pacific Orthopaedic Association. “Total joint replacement may be more dramatic, but arthroscopy has a greater effect on more people.” The article looks at advancements in shoulder arthroscopy since the first use of arthroscopy on a cadaver knee, in 1918. Shoulder arthroscopy has not only changed surgical options but also has facilitated greater understanding of shoulder injuries and diseases. For example, new lesions, such as the SLAP lesion, were detailed and classified only after arthroscopy became available. Read more . . .

Potential Advance in Rotator Cuff Tendon Repair

Rotator cuff tendon tears that “are severe or persistent enough to require rotator cuff surgery may not heal after a procedure,” states an article on the University Hospitals website. “Healing rates vary anywhere from 6 to 90 percent. Age, tear size, fatty infiltration and atrophy all contribute to degeneration and slow healing rates.”

To address this problem, scientists at Case Western Reserve University’s Orthopaedic Bioengineering Laboratory (OBL) have developed a tendon-like material to bridge the gap between a patient’s tendon and the bone. The material is composed of a scaffold using woven collagen threads, which are aligned using electric currents. The scaffold can be used in conjunction with mesenchymal stem cells (MSC) from the patient’s bone marrow used to regenerate new tissue. The procedure is still in the animal testing phase.

“Very few pieces of technology have the chance to be disruptive in orthopaedic surgery and change the way we treat certain conditions, but this novel graft may have the ability to do that for severe tendon injuries,” said Robert Gillespie, MD, Chief of the Shoulder and Elbow Surgery Division of University Hospitals Cleveland Medical Center.  Read more . . .


L Shoulder Rotator Cuff Repair
This is a 21-minute video of a surgery by Dr. Don Bufurd, MD, RMSK, of the Texas Orthobiologics Institute. More videos and information are available at his YouTube channel and his website. Watch now…

Total Shoulder Replacement
In this 1-hour-plus video, Ethan R. Wiesler, MD, an orthopaedic surgeon at Wake Forest Baptist Medical Center, performs a total shoulder replacement. For more information about the Wake Forest Baptist Health, go to their websiteWatch now…

Breast Surgery Crossword Puzzle

Test your knowledge of breast surgery procedures with this month’s all-new crossword puzzle.

When you’re ready to check your answers, follow this link to see how well you did. Good luck!

Student Spotlight: Amy Purkey

Amy Purkey


Student Status  
Current student in NIFA’s RNFA program

City & State  
Keizer, OR

Current Position 
Nurse Practitioner working with the Trauma and General Surgery team at Salem Health in Salem, Oregon 

Where did you get your nursing degrees?  
Chemeketa Community College—RN, Grand Canyon University—BSN, Gonzaga University—MSN.

How did you come to choose perioperative nursing? 
After 10 years in the ICU and after obtaining my FNP, I landed a job with the trauma team at the hospital I started in. 

What is one technique or RNFA trick you learned at the SutureStar workshop that you will use for life?  
Single-handed knot tying.

How do you feel having your RNFA will impact your life/career? 
It will open doors for me personally and professionally.

Jobs Front

Click here for the RNFA job postings we’ve collected for you this month.

NIFA – Office Hours

Monday-Thursday, 8:00am – 4:00pm
Friday, 8:00am – 3:00pm

Practice Resources

Here are several of the most-in-demand sites for our students, prospective students and grads:

MD Edge Surgery News: Specialty News and Commentaries, Videos and More
RNFA Scope of Practice by State (PDF)
ACS List of Cases that Require an Assistant at Surgery, 2018 (PDF)
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links

Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.

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