Episode 65: Dr. Sarav Shah - The Future of Shoulder Surgery: Innovation, Predictability & What Really Determines Success

As surgical techniques for the shoulder evolve and the number of arthroplasty procedures in younger patients continues to skyrocket, how can clinicians balance aggressive innovation with predictable patient outcomes?In this episode, Dr. Sarav Shah—Chief of the Division of Sports Medicine at New England Baptist Hospital—joins hosts Andrew Rizza and Dr. Cameron Roth to discuss the complex world of shoulder surgery.The conversation examines the startling 300% increase in shoulder replacements for patients under 50 and the emerging "buying time" procedures, such as Lower Trapezius Tendon (LTT) transfers, designed to delay the start of the arthroplasty clock. Dr. Shah shares his perspective on why machine learning is poised to have a far greater impact on surgical success than current robotic systems.The discussion dives into debates in shoulder surgery, including the use of balloon spacers for massive rotator cuff tears, the role of social determinants of health in orthopedic outcomes, and why elite athletes often return to sport faster after surgery than amateurs. Dr. Shah also offers advice for young clinicians hoping to build careers and pursue leadership roles in sports medicine.MEET THE GUEST Dr. Sarav Shah, MDOrthopedic surgeon Chief, Division of Sports Medicine, New England Baptist HospitalCo-Director, New England Baptist Hospital Sports Medicine and Shoulder & Elbow FellowshipsTOPICS DISCUSSEDWhy elite athletes often return to sport faster after surgeryThe 300% increase in shoulder arthroplasty for patients under 50The impact of social determinants of health on surgical outcomesDebates around balloon spacers for massive rotator cuff tearsEmerging procedures such as lower trapezius tendon transferHow machine learning is transforming surgical decision-makingHIGHLIGHTS00:55 – Dr. Shah's Path into Orthopedic Surgery & Shoulders02:43 – Mentorship with Dr. David Dines04:09 – Collaborative Care: Working with PTs & Athletic Trainers06:00 – Improving Patient Experience Through Communication07:29 – How Much Information Is Too Much for Patients?08:37 – Patients Who "Heal Themselves" Before Surgery11:30 – Second Opinions: Talking Patients into or out of Surgery?12:35 – Major Advances in Shoulder Clinical Outcomes14:36 – The Increase in Arthroplasty for Patients Under and Over 5015:53 – Has the Pendulum Swung Too Far Toward Reverse Arthroplasty?18:33 – The Future of AI and Machine Learning in Surgery20:31 – Emerging Technologies Dr. Shah Is Excited About21:26 – The New Wave of Rotator Cuff Augmentation24:05 – Treating Elite Athletes vs. the General Population25:15 – Managing Biological Healing Expectations and Protocols26:46 – How Social Determinants of Health Influence Outcomes28:57 – Reducing Complications for High-Deprivation Index Patients29:46 – Balloon Spacers for Massive Irreparable Rotator Cuff Tears31:06 – Advice for Clinicians Who Want Leadership Roles32:53 – Lightning Round: Biggest-Impact Procedures34:13 – One Surgical Intervention That Changed His Practice35:21 – The Research Question Dr. Shah Wishes He Could Answer36:27 – The Best Advice from a Mentor36:49 – Staying Balanced Outside of Medicine37:18 – What He Hopes Changes in Sports Medicine in 10 Years38:11 – Why He Completed a Shoulder/Elbow Fellowship After Sports MedicineQUOTE:31:22 - “If you want to be the best that you can be, you've got to put in the effort and time. And it's not just showing up, it’s not just caring in the room. If you care about the patient, go home and read. You go home and read, you'd be the most knowledgeable, most independent, hone your skills, go to all the labs that are offered, hone your skills to be the best surgeon, best physician, best scientist you can be. And that's how you take the best care of your patients.” LINKS: Dr. Sarav Shah, MD: https://nebh.org/find-a-doctor/sarav-shah-md “A novel approach to improving patient experience in orthopedics”: https://journals.sagepub.com/doi/abs/10.1177/1062860617691124 Dr. Shah’s papers: https://scholar.google.com/citations?user=SPUf5tQAAAAJ&hl=en DISCLAIMER The opinions presented on Behind the Sports Medicine are those of the host and guests. They do not necessarily reflect the opinions of any affiliated institutions or partners. The content is for informational purposes only and does not constitute medical advice. Always consult a licensed medical professional before making any health or treatment decisions. Behind the Sports Medicine and its affiliates assume no liability for the accuracy or application of the information discussed.#OrthopedicSurgery #ShoulderSurgery #RotatorCuff #ShoulderArthroplasty #SportsMedicine