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Last Updated: Friday, 20 May, 2005, 23:30 GMT 00:30 UK
'I want a new shoulder to last my lifetime'
By Jane Elliott
BBC News health reporter

Terry Molloy
Terry's shoulder replacement allows him to play golf again
Terry Molloy was running late the day of the Ladbroke Grove rail crash, which could have saved his life.

Normally Terry, 50, travelled first class, but he was forced to jump into a second-class compartment at the last minute.

He escaped the crash, which killed 31 and injured 500, with minor injuries - a fractured collarbone and a dislocated shoulder.

But his shoulder injury turned out to be more troublesome than doctors first expected.

Operations

Mr Molloy has now had three shoulder operations, including one to completely replace the joint, but experts say he could be facing at least one more as shoulder joints currently only last between 10 and 15 years.

A group of researchers from Imperial College, London, are trying to find out why the joints loosen and to improve their lifespan.

If there is a chance with the research for anybody in my situation to have something that lasts a little bit longer then I want them to go for it
Terry Molloy

The team of bioengineers and surgeons have been given a 58,000 grant from the Arthritis Research Campaign to fund the three-year- research, which they hope will enable them to create improved implant designs and better surgical techniques.

Researcher Andrew Wallace, a senior lecturer at Imperial College, London, and a consultant orthopaedic surgeon at St. Mary's Hospital in Paddington, London, said the aim is to create a prosthesis to last a lifetime.

He said that, because shoulder replacements are highly specialised, the public are not as aware of them as they are of knee replacements.

"In the past people were just told to live with their problems and were not aware of the benefits of shoulder replacements.

"We are now into the fourth generation of replacements and it is much easier to make one that can fit the patient and not the other way round."

But he said that the problems arose with the plastic sockets, which can loosen and shed tiny particles, causing further problems.

The ideal solution would be to be able grow new cartilage in the lab, but he admitted that this is some way off.

He added: "The best results last 15 years. The best replacement results are in somebody elderly with less demands on the joint.

The Paddington crash
The crash at Ladbroke Grove, near Paddington, killed 31 people

"The worst results are in younger people who've had an injury or trauma. Once you get rid of their pain and restore movement they naturally want to do more, so the joint gets more wear and you get problems with loosening in up to 30% of cases.

Replacements

"The challenge is to make an implant that we could use in a 45-year-old if there was no other reconstruction option."

Each year there are more than 50,000 hip and knee replacements, but only 5,000 shoulder replacements.

Mr Molloy said he would welcome any research that will give his shoulder replacement a longer lifespan.

"I am 50 and at the time of the accident I was 45. I was always facing the possibility of one, if not two, further operations to replace so if there is a chance with the research for anybody in my situation to have something that lasts a little bit longer then I want them to go for it."

The best replacement results are in somebody elderly with less demands on the joint
Andrew Wallace, consultant orthopaedic surgeon

He said his current replacement appeared to be working well and had relieved his pain, allowing him to go back to work full-time and play his golf, something he was not able to do before.

"After the crash they just thought the shoulder was bruised. I had broken my collar bone so I went to the hospital and they patched it up and gave me pain killers and put my arm in a sling.

"After about three to four weeks they sent me for some physiotherapy, but after six weeks it was not getting any better and they discovered it had been dislocated, but because of all the swelling it had not shown up.

"The muscles and scar tissue had grown and stopped it going back into its proper place."

A spokeswoman for the Arthritis Research Campaign said they were delighted by the work.

"Hip and knee replacement surgery is now carried out routinely and can transform the lives of people with arthritis, and we would like to see shoulder replacement becoming as successful."

"Hopefully this research will go some way to developing a better designed shoulder implant that lasts longer."




SEE ALSO:
Surgeon gives power to the elbow
25 May 04 |  Somerset
Hope for arthritis treatment
21 Sep 02 |  Health


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