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We recently had the opportunity to interview Dr. David Fehnel and learn more about his background and experiences using InSet™ Systems from Shoulder Innovations in his practice as an orthopedic surgeon. An edited version of our interview led by David Blue follows.

David Blue:

Thank you for joining us today. Would you share your background with us, including how you became involved in healthcare and what attracted you to orthopedics?

Dr. Fehnel:

I always knew I wanted to go into medicine, even back in high school while I was playing college sports, specifically lacrosse, and had a couple of injuries, though nothing too serious. I was always intrigued by the idea of becoming a physician who could take care of athletes, and I was particularly drawn to orthopedics right from the start.

So, I pursued my passion, attended Bucknell University for my undergrad, followed by medical school and residency at the University of Vermont. After that, I completed a sports and shoulder-specific fellowship at Duke University. During my time there, I had the opportunity to take care of various sports teams.

Fast forward to today, and I’ve been in practice for almost 24 years. While I’m not the oldest in my practice, I’ve witnessed significant changes in the field over the years.

David Blue:

What attracted you to shoulder as a subspecialty?

Dr. Fehnel:

This evolved during my residency and fellowship. I was exposed to various subspecialties, and mentors played a crucial role in sparking my interest. The strong sports and shoulder exposure at the University of Vermont solidified my fascination with shoulder injuries and surgery.

During my fellowship at Duke, I had a fantastic experience and mentorship under Dr. Kevin Speer, which further fueled my passion for shoulder surgery. I found myself naturally gravitating towards both arthroscopic and open shoulder procedures and knew I wanted to keep doing it.

Starting my own practice allowed me to focus on what I loved most, and over the years, I became more shoulder-centric. Today, I handle a wide range of shoulder-related cases, including adolescents, broken clavicles, labrum surgery, rotator cuff surgery, total shoulder replacements, and more. The diversity of cases keeps me engaged and constantly improving my skills.

I believe in being a master in one area rather than a jack of all trades, and my comprehensive shoulder practice reflects that philosophy. With the support of my Shoulder Innovations representative, I’m excited to continue evolving and contributing to the field of shoulder surgery.

David Blue:

Can you share your journey to the InSet™ Shoulder System? What were your initial impressions?

Dr. Fehnel:

I initially found the concept of using Shoulder Innovations intriguing and straightforward. As I started using their system, I began to appreciate its simplicity and effectiveness. Over time, my confidence in the system grew, and I noticed significant benefits for both myself as a surgeon and my patients.

I used both Shoulder Innovations and another system in my surgical center and hospital initially. I gradually transitioned to using Shoulder Innovations almost exclusively, and my surgical volume increased significantly.

What initially attracted me to Shoulder Innovations was the stem design for primary procedures. It made sense, preserved bone, and was user-friendly. I found that learning the system was relatively easy, and its bone-sparing characteristics were impressive.

Then, when the stemless option became available, it opened up a whole new world. The stemless shoulder implant is fantastic, offering even more versatility for primary cases.

However, what I absolutely love about Shoulder Innovations is the design of the Reverse. I’ve been performing reverse total shoulder surgeries since the early 2000s, and I’ve witnessed the evolution of these procedures over the years. Shoulder Innovations has truly transformed the game with the InSet™ Reverse shoulder system.

The engineers behind the Shoulder Innovations products are the same ones I worked with almost two decades ago, and it’s fascinating to see how they’ve evolved the designs over time. 

The Reverse total shoulder system in particular has been revolutionary. What sets this apart is its ability to create a shoulder that not only looks like an anatomic reverse but also feels like one. It offers stability without over-tensioning soft tissues and has made performing shoulder arthroplasty a joy for me. It’s made the surgeries exciting and has reignited my passion for the field.

Furthermore, the collaborative nature of sharing ideas and experiences among peers and within the Shoulder Innovations community has been invaluable. I have complete trust in my colleagues and peers in the industry, and their positive experiences with Shoulder Innovations further solidified my decision to embrace this system. 

This continues to be a rewarding journey, and as my surgical volume continues to grow, I’m excited about the future and the possibilities offered by Shoulder Innovations. The sense of community and collaboration within this community has been unlike anything I’ve experienced before, making it an even more fulfilling endeavor.

David Blue:

In what ways has the introduction of single tray technology for TSA and dual tray technology for RSA from Shoulder Innovations impacted efficiency and economic benefits in your experience?

Dr. Fehnel:

The simplicity and efficiency of this system is truly remarkable. One of the standout features for me is the use of a single-tray TSA or dual-tray RSA, instead of having to deal with four or five trays and various components. 

When I began transitioning all my cases to Shoulder Innovations, there was a humorous incident at the hospital. The surgical rep received an emergency call because they only had two trays, and they were wondering where all the other trays were. The truth was that everything was in those two trays, which was precisely what the rep wanted to convey. This highlights the system’s efficiency.

What’s even more incredible is that my surgical staff, who I’ve worked with for a long time, quickly adapted to the new system. Learning it was a breeze for them, and they found it much easier and more efficient. The system has reduced surgical time by about an hour for each case, which is a significant improvement. This not only means fewer trays to turn over but also substantial cost savings for the hospital and surgery center in terms of sterilization and inventory management.

From a financial perspective, Shoulder Innovations has been very competitive and cost-effective, making it easier for me to introduce the system to my hospital and surgical center. They have seen the benefits firsthand and are now interested in having other surgeons adopt the InSet™ system for the same reasons.

David Blue:

Any closing thoughts, Dr. Fehnel?

Dr. Fehnel:

Absolutely, as we continue to advance in the field of shoulder arthroplasty and design work, fostering a collegial and collaborative atmosphere like what Shoulder Innovations has cultivated among the docs is vital. This collaborative environment not only benefits the surgeons but also makes us feel valued and appreciated for our experiences and insights. Maintaining this sense of value and camaraderie helps to keep the field of orthopedics exciting and innovative. Many of us chose orthopedics because it’s a field where we can have fun and enjoy being involved in the development of new products and technologies. When you have great people to work with, the process becomes even more enjoyable.

For me, it’s not just about personal satisfaction but also about benefiting patients in the long run. We want to keep orthopedics a dynamic and thriving field, and Shoulder Innovations plays a significant role in that journey. Here’s to many more years of collaboration and innovation with the team!

Dr. David Fehnel is an Orthopedic Surgeon in Peabody, MA