Welcome to The UW Shoulder Site @ uwshoulder.com

Delta Shoulder



Please note that information on this site was NOT authored by Dr. Frederic A Matsen III and has not been proofread or intended for general public use.  Information was intended for internal use only and is a compilation for random notes and resources.


If you are looking for medical information about the treatment of shoulders, please visit shoulderarthritis.blogspot.com for an index of the many blog entries by Dr. Frederick A Matsen III.



Shoulder and Elbow Grafts




As you may be aware, each time we order a graft and send it back there is a $150 charge.  This adds up over time and can easily add up to thousands of dollars per year.  
We have a system that allows us to have grafts ready in a timely manner, without the waste created by having unnecessary grafts in the room on cases that end up not requiring a graft. The key is determining whether a graft will be necessary or just a remote possibility.
Here is what we need to do:


  1. If we need a special unique graft (entire scapula of certain size, distal humerus, etc), we will need to order this through NW Tissue Services and contact the implant room with the order number.  Note that some grafts may require several months to obtain.
  2. If we need a hamstring or other common graft and plan on using it, we will need to add that to the surgical worksheet and double check with the implant room prior to surgery.
  3. If there is a possibility of needing a graft (such as a hamstring allograft for a subscapularis repair), but we feel that it is unlikely that we will use it, we should add the graft to the surgical worksheet and write “ON HOLD.”  We should check with the implant room prior to surgery to ensure that the graft has been ordered and is on hold.


On the morning of the day of surgery, someone from the team should touch bases with the implant room to make sure ON HOLD grafts are on hold and that ordered grafts are in house.  Ideally, that person should put their hand on each Styrofoam container containing the graft to make sure that each graft is actually there and none have been inadvertently sent back.
When setting up the pt in room, you should ensure that the graft has actually made it to the proper OR prior to surgery.
During surgery, if you decide that you will need the ON HOLD graft – tell the circulator to call the implant room to get the graft delivered.  This can take between 30-60 minutes depending on traffic – so timely decision making during the case is important to prevent excessive delays.