In English

The Finnish Society for Shoulder and Elbow Surgery hosted the 8th Triennial Nordic Shoulder and Elbow Conference in Helsinki 16.-17.5.2019.

Triennial? Yes, meaning that since 1998, the shoulder and elbow specialists from Sweden, Norway and Denmark have gathered together every three years to ponder on the fascinating art of treating patients with musculoskeletal complaints around these joints. And how does Finland fit into this picture? After careful consideration – according to the rumors, and a lot of good-old Finnish style persuasion – we Finns were finally accepted to this prestigious group and given the honour of hosting the 8th such gathering in Finland.

Finns took on the challenge under the leadership of Dr. Ilkka Sinisaari and under the auspices of the Finnish Society for Shoulder and Elbow Surgery (FSSES). The program committee was chaired by Dr. Mika Paavola along with Kaisa Lehtimäki from Turku.

A pre-course event gave us the opportunity to meet colleagues and friends (old and new) from the Nordic countries and the rest of Europe in a relaxed atmosphere and introduce them to some of the most important aspects of Finnish culture: water, sauna and food. We started out on a boat ride through the Helsinki archipelago, built up some steam in a traditional Finnish smoke sauna and enjoyed some flame grilled salmon afterwards.

Finnish archipelago



Building up steam in the smoke sauna

Thursday started off with a welcome speech by Ilkka Sinisaari (President of the Finnish Society of Shoulder and Elbow surgery), followed by a symposium on scientific evidence and clinical practice. To kick off the first session, the FICEBO leadership (Teppo Järvinen and Simo Taimela) took the stage and gave the audience a crash-course on clinical epidemiology. But the true star of the session was Dr. Imran Sajid, who gave an amazing talk on the psychology behind resistance to change.


In the session that followed, entitled “When the going gets tough”, some of the most esteemed shoulder and elbow surgeons in the world shared their opinions and experiences with the audience: Lionel Neyton (Lyon) talked about glenoid bone loss, Karl Wieser (Zürich) about posterior shoulder instability and glenoid retroversion, Tapio Flinkkilä (Oulu) about dysfunction and pain after reverse prosthesis and Lars Adolfsson (Linköping) about elbow instability.

The first day was drawn to a close – according to some visitors – by one of the best free paper sessions seen in recent years. Kari Kanto presented the 5-year results of our FIMPACT trial and Simo Taimela shared the 2-year results of the same trial on return to work -outcomes. Tuomas Lähdeoja summarized the results of a systematic review on subacromial decompression surgery. Our FICEBO researchers were in great company: Juha Kukkonen and Stefan Moosmayer presented their 5- and 10-year data on rotator cuff surgery (repair vs. conservative treatment), while Janne Lehtinen and Juha Paloneva rounded up the session with their 2- and 12-year follow-up results of RCTs on subacromial pain surgery.

The Friday morning sessions were dedicated to upper extremity fracture treatment. Lasse Rämö talked about trigger points for operative treatment in humeral shaft fractures in the first session and presented fresh-out-of-the-oven 1-year results of an RTC comparing ORIF versus functional bracing for humeral shaft fractures.

Lasse preparing for his talk on humerus shaft fractures

Among the contributors, Tore Fjalestad (Norway) talked about greater tuberosity fractures, Bakir Sumrein (Tampere) about results from a re-categorized Neer classification for proximal humerus fractures, Antti Launonen (Tampere) about 2 year RCT results of displaced two-part humerus fractures comparing ORIF versus non-operative treatment, and Hanna Björnsson-Halgren (Sweden) about results comparing two different surgical approaches when treating distal humerus fractures.

In summary, the meeting was a great show of high-quality research performed in the Nordic countries and increasing collaboration between individual researchers and research groups.

Thank you all and see you again in Norway in three years’ time!

Course Certificate

Course Pictures




The Finnish Society for Shoulder and Elbow Surgery (FSSES)

Suomen Olkakirurginen Yhdistys (SOKY)


The Finnish Society for Shoulder and Elbow Surgery was founded in 2002. The object of FSSES is to promote surgical skills, understanding and research in the field of shoulder and elbow surgery.

We organize two annual conferences for our members. The conferences take place at different locations around Finland. The board of the society and new members will be elected in the general meeting of FSSES that will be held every spring. We aim to strengthen co-operation between specialists that are involved in treating patients with shoulder or elbow disorders.

Contact us


You may apply for membership to FSSS if you are interested in and/or practice shoulder and elbow surgery on daily basis. In order to be accepted your application must be endorsed by two current members of the society. Members from industry are also welcome.


One priority of FSSES is to provide a network for research collaborations. Especially, our members conduct several multicenter randomized controlled trials in the field of shoulder and elbow surgery such as; operative versus non-operative management of shoulder impingement syndrome (Paavola et al 2017 and Identifier: NCT00637013) and rotator cuff tear (NCT00695981, Kukkonen et al 2014, Kukkonen et al 2015), traumatic shoulder instability (NCT02885714) and proximal humeral fractures (Launonen et al 2012). Members of our society also participate in preparation of national current care guidelines.


We work closely with the Finnish Orthopaedic Association.

BOARD members:

Juha Paloneva,  Chairman

Thomas Ibounig, Secretary

Ilkka Sinisaari, Tresurer

Juha Kukkonen

Janne Lehtinen

Kaisa Lehtimäki

Minna Natunen, Industry board member

Recent Publications:

The short-term survival of total stemless shoulder arthroplasty for osteoarthritis is comparable to that of total stemmed shoulder arthroplasty: a Nordic Arthroplasty Register Association study. Rasmussen JV, Harjula J, Arverud ED, Hole R, Jensen SL, Brorson S, Fenstad AM, Salomonsson B, Äärimaa V. J Shoulder Elbow Surg. 2019 Aug;28(8):1578-1586. doi: 10.1016/j.jse.2019.01.010. Epub 2019 Apr 28.

Operative versus non-operative treatment for 2-part proximal humerus fracture: A multicenter randomized controlled trial. Launonen AP, Sumrein BO, Reito A, Lepola V, Paloneva J, Jonsson KB, Wolf O, Ström P, Berg HE, Felländer-Tsai L, Jansson KÅ, Fell D, Mechlenburg I, Døssing K, Østergaard H, Märtson A, Laitinen MK, Mattila VM; as the NITEP group. PLoS Med. 2019 Jul 18;16(7):e1002855. doi: 10.1371/journal.pmed.1002855. eCollection 2019 Jul.

Acute Cuff Tear Repair Trial (ACCURATE): protocol for a multicentre, randomised, placebo-controlled trial on the efficacy of arthroscopic rotator cuff repair. Ryösä A, Kukkonen J, Björnsson Hallgren HC, Moosmayer S, Holmgren T, Ranebo M, Bøe B, Äärimaa V; ACCURATE study group. BMJ Open. 2019 May 19;9(5):e025022. doi: 10.1136/bmjopen-2018-025022.

Nordic Innovative Trials to Evaluate osteoPorotic Fractures (NITEP) Collaboration: The Nordic DeltaCon Trial protocol-non-operative treatment versus reversed total shoulder arthroplasty in patients 65 years of age and older with a displaced proximal humerus fracture: a prospective, randomised controlled trial. Launonen AP, Fjalestad T, Laitinen MK, Lähdeoja T, Ekholm C, Wagle T, Mattila VM; NITEP-group. BMJ Open. 2019 Jan 29;9(1):e024916.

Subacromial decompression surgery for rotator cuff disease. Karjalainen TV, Jain NB, Page CM, Lähdeoja TA, Johnston RV, Salamh P, Kavaja L, Ardern CL, Agarwal A, Vandvik PO, Buchbinder R. Cochrane Database Syst Rev. 2019 Jan 17;1:CD005619.

Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis. Lähdeoja T, Karjalainen T, Jokihaara J, Salamh P, Kavaja L, Agarwal A, Winters M, Buchbinder R, Guyatt G, Vandvik PO, Ardern CL. Br J Sports Med. 2019 Jan 15. pii: bjsports-2018-100486.

Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis. Kavaja L, Lähdeoja T, Malmivaara A, Paavola M. Br J Sports Med. 2018 Dec;52(23):1498-1506.

Intraobserver and interobserver reliability of recategorized Neer classification in differentiating 2-part surgical neck fractures from multi-fragmented proximal humeral fractures in 116 patients. Sumrein BO, Mattila VM, Lepola V, Laitinen MK, Launonen AP; NITEP Group. J Shoulder Elbow Surg. 2018 Oct;27(10):1756-1761.

Risk and risk factors for revision after primary reverse shoulder arthroplasty for cuff tear arthropathy and osteoarthritis: a Nordic Arthroplasty Register Association study. Lehtimäki K, Rasmussen JV, Mokka J, Salomonsson B, Hole R, Jensen SL, Äärimaa V. J Shoulder Elbow Surg. 2018 Sep;27(9):1596-1601.

Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: randomised, placebo surgery controlled clinical trial. Paavola M, Malmivaara A, Taimela S, Kanto K, Inkinen J, Kalske J, Sinisaari I, Savolainen V, Ranstam J, Järvinen TLN; Finnish Subacromial Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators. BMJ. 2018 Jul 19;362:k2860.

Increasing incidence of primary shoulder arthroplasty in Finland – a nationwide registry study. Harjula JNE, Paloneva J, Haapakoski J, Kukkonen J, Äärimaa V; Finnish Shoulder Arthroplasty Registry Group. BMC Musculoskelet Disord. 2018 Jul 21;19(1):245.

Long-term results of arthroscopic Bankart repair: Minimum 10 years of follow-up. Flinkkilä T, Knape R, Sirniö K, Ohtonen P, Leppilahti J. Knee Surg Sports Traumatol Arthrosc. 2018 Jan;26(1):94-99.

Discovery Elbow System: clinical and radiological results after 2- to 10-year follow-up. Hänninen P, Niinimäki T, Flinkkilä T, Niinimäki J, Ohtonen P, Yli-Luukko S, Leppilahti J. Eur J Orthop Surg Traumatol. 2017 Oct;27(7):901-907.

Surgery or conservative treatment for rotator cuff tear: a meta-analysis. Ryösä A, Laimi K, Äärimaa V, Lehtimäki K, Kukkonen J, Saltychev M. Disabil Rehabil. 2017 Jul;39(14):1357-1363.

Trends in the Incidence of Clavicle Fractures and Surgical Repair in Sweden: 2001-2012. Huttunen TT, Launonen AP, Berg HE, Lepola V, Felländer-Tsai L, Mattila VM. J Bone Joint Surg Am. 2016 Nov 2;98(21):1837-1842.

[Update on current care guidelines: The tendon disorders of the shoulder]. Lepola V, Paloneva J, Huuskonen M, Karppinen J, Mattila K, Mattila VM, Raittinen J, Rautiainen J, Takala E-P, Äärimaa V.Duodecim. 2015;131(2):194-5. Finnish.

Treatment of Nontraumatic Rotator Cuff Tears: A Randomized Controlled Trial with Two Years of Clinical and Imaging Follow-up. Kukkonen J, Joukainen A, Lehtinen J, Mattila KT, Tuominen EK, Kauko T, Äärimaa V. J Bone Joint Surg Am. 2015 Nov 4;97(21):1729-37

Increasing incidence of rotator cuff repairs–A nationwide registry study in Finland. Paloneva J, Lepola V, Äärimaa V, Joukainen A, Ylinen J, Mattila VM. BMC Musculoskelet Disord. 2015 Aug 12;16:189.

Treatment of proximal humerus fractures in the elderly: a systemic review of 409 patients. Launonen AP, Lepola V, Flinkkilä T, Laitinen M, Paavola M, Malmivaara A. Acta Orthop. 2015 Jun;86(3):280-5.

The effect of tear size on the treatment outcome of operatively treated rotator cuff tears. Kukkonen J, Kauko T, Virolainen P, Äärimaa V. Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):567-72.

Treatment of non-traumatic rotator cuff tears: A randomised controlled trial with one-year clinical results. Kukkonen J, Joukainen A, Lehtinen J, Mattila KT, Tuominen EK, Kauko T, Aärimaa V. Bone Joint J. 2014 Jan;96-B(1):75-81

Investigating minimal clinically important difference for Constant score in patients undergoing rotator cuff surgery. Kukkonen J, Kauko T, Vahlberg T, Joukainen A, Aärimaa V. J Shoulder Elbow Surg. 2013 Dec;22(12):1650-5.

 Conservative treatment, plate fixation, or prosthesis for proximal humeral fracture. A prospective randomized study. Launonen AP, Lepola V, Flinkkilä T, Strandberg N, Ojanperä J, Rissanen P, Malmivaara A, Mattila VM, Elo P, Viljakka T, Laitinen M. BMC Musculoskelet Disord. 2012 Sep 7;13:167.