NMCSD orthopaedic surgeon wins 2009 Academic Research Competition
7/29/2009
by Hospital Corpsman 3rd Class Sean Evans
SAN DIEGO (NNS) -- An orthopaedic surgeon from Naval Medical Center San Diego received first place at the 2009 Academic Research Competition (ARC) in Bethesda, Md., for his recent advancements in surgical shoulder repair.

Three naval teaching hospitals were represented at the competition; Bethesda, Md. and Portsmouth, Va. and San Diego, Calif. Lt. Cmdr. Michael T. Provencher's research study was chosen over two others as the San Diego representative to the national research competition.

Provencher's research study focused on a shoulder condition identified in active duty military personnel known as circumferential tears of the labrum (cartilage). The labrum is a 360-degree structure and is occasionally torn to its full circumference. However, in a number of the cases involved in Provencher's study, full circumference of the labrum was compromised. This condition is most commonly associated with instability and dislocation of the shoulder. Provencher achieved a 90 percent post-operative recovery success rate.

"As extensive an injury to the shoulder joint as this is, a large number of service members returned to full duty with a high level of function in their surgically repaired shoulder," said Provencher.

In the diagnosis and treatment of shoulder injuries, Provencher noted two valuable factors contributing to the success of his research study: the development of a more thorough interview regarding the history of ailment prior to surgery and the use of the Magnetic Response Imaging (MRI) arthrogram. The MRI arthrogram is an image which displays more detail in the interior of the joint than a standard MRI. Arthrogram refers to an injection that emits a contrast agent into the problem area to enable a clearer interpretation and a more accurate assessment.

The Society of Military Orthopedic Surgeons (SOMOS) is a group of Army, Navy and Air Force surgeons, as a multicenter study, Provencher worked jointly with Cmdr. (Dr.) Daniel J. Solomon and Lt. Col. (Dr.) John T. Tokish, of the U.S. Air Force Academy. Provencher referred to the research team as "the SOMOS research collaborative, a coalition of the willing." The surgeons joined forces and shared findings in an effort to increase the success of surgery across the continuum of surgical excellence.

Most often, shoulder injuries start with an anterior instability event and become progressively worse when left untreated, according to Provencher.

"Some of the unique demands of the military are not always applicable to the civilian population," said Provencher. "It is vital for service members to seek medical care early in order to remedy the injury before it becomes severe and more difficult to treat." Patients are encouraged to see their primary care manager (PCM) if shoulder instability, pain, or discomfort is experienced.

Provencher noted that military patients often try to cope with the pain associated with frequent shoulder dislocations. Patients are urged to see their PCM if continued unpleasant discomfort is experienced. There is no need to tolerate pain and feelings of shoulder "looseness" unnecessarily.

"Lt. Cmdr. Provencher's work will help our department treat serious injuries to the shoulder in active duty Sailors and Marines," said Capt. (Dr.) Dana C. Covey, chairman of the department of orthopaedic surgery. "His work has shown that complex labral tears of the shoulder can be successfully treated through minimally invasive (arthroscopic) surgery performed as same-day surgery. This treatment enables most patients to markedly improve and thus return to their usual activities including deployments."

Provencher attended the United States Naval Academy from 1989 to 1993 majoring in electrical engineering. He then attended Dartmouth Medical School from 1994-1998. Provencher has served in the United States Navy since 1998. A finalist in more than 25 regional and nationwide research competitions throughout his tenure in the U.S. Navy, Provencher has placed first in the majority of the additional research competitions.

In addition to his research recognition, Provencher was promoted early this year to principal reviewer of the American Journal of Sports Medicine. Provencher and his colleagues' advancements in surgical shoulder repair have contributed to greater operational readiness throughout the command, and provided a greater resource of deployable personnel.