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Read a features below by Aultman Hospital in the Canton Repository from July 2011. Other orthopaedic feature articles can be found here.

New Surgery Helps Rotator Cuff Sufferers

There is hope if you are experiencing unrelenting pain from a rotator cuff tear, according to Dr. Gerald Klimo, and you have been told it can’t be surgically repaired.

“It’s a devastating condition that seriously compromises the comfort and function of the shoulder,” said Klimo who has been offering a state-of-the art procedure since 2007 at Aultman Hospital called reverse shoulder arthroplasty. It’s a procedure that many don’t know about.

“I see the pain and tears on their faces before surgery. They have difficulty lifting their arm and have pain 24 hours a day,” said the orthopaedic surgeon who specializes in hand and upper extremities with a special focus on shoulders.

He is one of a few surgeons in the region who is trained to do the procedure with a unique prosthesis. The ball and socket are "reversed" or switched compared to a standard shoulder prosthesis that is used when the rotator cuff tendons are still intact.

According to Klimo, the reverse shoulder prosthesis provides a fixed fulcrum (or pivot) for the shoulder joint, allowing the arm to be raised overhead even when the rotator cuff muscles are damaged beyond repair.

“Physical therapy is an important part of recovery and starts the first day,” Klimo said. “Patients are so relieved and happy that they have minimal pain and have regained 70-80 percent of their range of motion around eight weeks after their surgery.”

In addition to helping people become pain-free, Klimo is passionate about training and educating other surgeons to perform this very technical procedure. To do so, he has traveled to Spain, Brazil and throughout the United States to lecture at conferences, instruct on cadavers and perform live video-conference surgery. Klimo has also been instrumental in developing new surgical instruments to simplify the procedure.

“I enjoy teaching surgeons the reverse shoulder arthroplasty technique because I know that exponentially more patients will be helped as additional surgeons are trained. Physicians have come to Aultman to learn from me,” he said.  

About 65 percent of Klimo’s patient care is for shoulders, and he’s in the top 5 percent in the nation for volume of shoulder replacement surgeries.

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Shoulder Injuries Don’t Hold Back Malvern Man

Ray Carpenter injured his right shoulder when he fell from a rooftop during work. Although it was a little painful, it really didn’t warrant going to the doctor through the years, he thought. Little did he know that injury and scar tissue would impact his medical care 30 years later.

In December, while the 83-year-old was alone in Florida, he fell on the same shoulder. This time he was in agonizing pain. “I knew it was bad, very bad,” he said.

A trip to the ER there proved the shoulder was out of socket and the rotator cuff tore in two places. So he wore a sling and did very little until he could fly home to see Dr. Gerald Klimo, as a friend recommended.

An MRI clearly showed the old and new rotator cuff injuries, which eliminated the option for a traditional shoulder replacement.

“I would have been worthless without a new shoulder,” he said. “I was in so much pain and had basically no use of my arm.”

As luck would have it, Klimo also had the unique ability to perform a reverse shoulder replacement to help uncommon injuries like Carpenter’s. 

“Everything Dr. Klimo told me about the surgery is true. I’m amazed at my quick recovery. My shoulder is the best it has been in more than 30 years.”

In fact, with some assistance Carpenter could lift his arm all the way up with little pain even the day after surgery. And after just about one month of physical therapy, he regained about 85 percent of his motion back.

Carpenter’s daughter Sandy Jones is so pleased with her dad’s recovery. “That fall really did him. He has always been very independent and likes to help others using his carpenter skills for family and friends’ home repairs. The surgery made it a happy ending!” she said.

The Malvern resident is proud he can still ride a motor trike as well as play the organ at church and for residents at about seven area nursing homes. He’s particularly impressed that he’s able to manage the bike’s hand throttle which is on the right side, and play “concerts” that are about an hour.

“I’m just so happy to be alive. I can flip pancakes and cook eggs,” he joked. “I never have problems with my shoulder, other than some minor stiffness when I don’t do my exercises at home.”

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