Knoxville attorney Don Vowell makes no bones about it – when his shoulder went out for the umpteenth time, he wanted an expert.
“Shoulder replacements are really not that common and I have a history of dislocated shoulders so I wanted a surgeon who had done a lot of shoulder surgeries,” said Vowell, adding that he had “at least three dozen” dislocations before doctors suggested that he give up soccer and basketball “With all that history, I wanted somebody who had done a lot of shoulder replacements.”
He found one in Edwin Spencer, MD, an award-winning orthopedic surgeon at Parkwest Medical Center whose skill extends to the research lab where he’s helped design several different kinds of artificial shoulder replacement components.
Among those are an augmented glenoid and a stemless shoulder replacement, both of which were used in Vowell’s surgery.
“So that’s two major advancements that just happened to come out within six months of each other,” said Dr. Spencer, who was named one of the top 28 orthopedic surgeons in the U.S. a few years ago. “We were working on them concomitantly, running parallel lines in our design projects. So Don got all the high-tech stuff.”
The glenoid is the shallow socket in the shoulder blade where the head of the upper arm bone fits into the shoulder. Because the head is larger than the socket, its instability makes it vulnerable to injury but allows for a complex range of motion. The socket is also susceptible to wear and osteoarthritis, making repair difficult.
Osteoarthritis and overuse most often wears away at the front side of the glenoid. But in 40 percent of cases, including Vowell’s, the bone loss is in the back, or posterior, of the glenoid. “We are still trying to figure out exactly why males, in particular, get that wear pattern,” said Dr. Spencer. “But we do and it’s nice to have a component where we can re-center it and get it back to where it was before.”
“For years, we didn’t have a component (artificial substitute) that could address that,” he added. “So we did the best we could until we designed this component. When we found hard data where we could see this tri-modal distribution of bone loss, we decided to make components that would fit all three of those modes. So, with that, we were able to better balance and center the joint which works out better for the patient because they no longer have a joint that’s off to one side.”
In addition to the augmented glenoid which helps prevent bone loss, Vowell received a stemless shaft that fits into the shoulder (or humerus) joint. The stemless prostheses is the first of its kind in the United States, and allows surgeons to more accurately recreate the patient’s normal anatomy without stem-related complications such as fractures, loosening or extraction.
In fact, it was during the course of Vowell’s rehabilitation that he learned Dr. Spencer also shared a love of mountain biking, and recently invited him to the new mountain bike trails at Baker Creek Preserve.“I don’t operate on patients if they’re not that active,” said Dr. Spencer. “What I try to do is match the surgery with the patient. Someone who is not going to be that active is not going to need the highest tech stuff. We try to stratify our patients and maximize their health and our surgery.”
Vowell is more than pleased with his outcome. He was only in Parkwest overnight, but it was long enough to be impressed.
“I would rate Parkwest and the nursing staff as excellent,” he said. “I was sedated and forgot their names but the nurses were unbelievable. I will never forget them! They were great.”
And Dr. Spencer?
“Dr. Spencer was more than excellent,” said Vowell, more than happy that he’d found the expert he wanted – an expert that he hopes to meet on the trails again soon.