We recently had the opportunity to meet with Robert Gillespie, M.D., specifically to talk about his background, and his experiences using the InSet Glenoid from Shoulder Innovations.
Dr. Robert Gillespie is an Orthopedic Surgeon and the Chief of Shoulder and Elbow Surgery at University Hospitals in Cleveland, OH.
David Blue: Dr. Gillespie, would you please share your background with us, including how you became involved in healthcare and specifically orthopedics?
Dr. Gillespie: I went into orthopedics mainly because of my early exposure to medicine from my family as well as it being a distinct specialty that allows us to return patients to activities that they love to do. This makes orthopaedic surgery very rewarding.
My father is a cardiologist, and my sister is a Family Med/Sports Medicine doc. My grandfather was an orthopedic surgeon, and my mom was an occupational therapist. I do have one other sister who is not in medicine – she passes out at the sight of blood, so it wasn’t for her.
For a while, I was trying to decide if I wanted to go into medicine or whether I wanted to become a teacher. I found that medicine would allow me to do everything that I wanted to do — taking care of people, teaching, and doing research.
I graduated from Jefferson Medical College in 2005 and then did my residency at Case Western Reserve University in Cleveland, Ohio. Then did my shoulder and elbow fellowship at the Rothman Institute in Philadelphia under the guidance of Dr. Gerry Williams, Dr. Matt Ramsey, and Dr. Mark Lazarus.
Since then, I’ve been back at Case Western Reserve University in Cleveland, Ohio, doing primarily shoulder and elbow.
I’ve been the Associate Program Director for the residency training program for four years and a year and a half ago transitioned to becoming program director. For the last 5 years, I’ve been the Chief of Shoulder and Elbow Surgery at University Hospitals in Cleveland as well.
David Blue: What was it that attracted you to the shoulder and elbow as a sub-specialty?
Dr. Gillespie: The shoulder and elbow are some of the most complex joints, that often makes them a challenge to treat. There is also a huge opportunity for growth for our treatment of many shoulder and elbow conditions
I actually had surgery on my shoulder when I was in medical school. At that point, I became really interested in the shoulder, and it progressed on from there.
From an orthopedic standpoint, one of the best things about our job is being able to take care of people. Helping to get them back out doing the things they love and getting them back to having a pain-free lifestyle. As a surgeon, that’s very rewarding and makes orthopedics, and specifically shoulder, really fun.
David Blue: How did you first learn about the Inset Glenoid, and the Shoulder Innovations team?
Dr. Gillespie: This goes back to my time in fellowship with Dr. Gerry Williams. Dr. Williams is a surgeon who always proactively looks for innovation to help his patients.
We would often have patients with really complex glenoid anatomy that Dr. Williams felt would do well with an anatomic shoulder replacement, and so we used the InSet Glenoid a couple of times then.
Personally, I became very interested again in Dr. Gunther’s work with Shoulder Innovations in the last few years as I was pursuing a solution that would decrease my patients’ chances of having glenoid loosening, and ultimately failure of their glenoid after anatomic shoulder replacement.
David Blue: What has been your personal experience in using the InSet Glenoid?
Dr. Gillespie: For the past two years, I have used the InSet with almost every patient who requires an anatomic shoulder replacement. I’m also using the Shoulder Innovations InSet short stem humeral component as well.
The reason I love the InSet Glenoid for these patients is that I can use it to correct retroversion, up to about 20-25 degrees at this time. It gives me excellent stability, great fixation, and very little risk of the rocking horse type phenomenon that we often see with onlay glenoid implants that can contribute to early failure.
Pain relief has been excellent with my patients.
There is also real ease of use of this implant system as there is only one tray for the entire anatomic system. My staff loves it because it’s really easy to use and set up.
I also see my indications continuing to grow as Shoulder Innovations releases some of their upcoming implants.
David Blue: If you were sitting down with a fellow surgeon to talk to them about this technology for the very first time, what would you tell them?
Dr. Gillespie: This is patented technology that has not really been seen much, but the early results are really impressive and may potentially be disruptive technology in shoulder replacement.
Dr. Gunther’s published long-term clinical data and successful results continues to become true for me as I have now witnessed firsthand his success with this implant in my own patients. This is also true for many of my colleagues who are also using this InSet system. In addition, as this InSet shoulder system continues to be expanded out to more of the general orthopedic surgery population, I personally believe that we won’t have to worry as much about glenoid failures as we do with the “gold standard” of an onlay glenoid. This really puts the emphasis again on anatomic reconstruction of the shoulder.
Additionally, the InSet helps me minimize the amount of bone that I have to remove. I am confident that these would be relatively easy to revise if needed. It allows me to resurface the joint as we have always wanted to.
David Blue: Do you have any tips or pieces of advice that you would give other surgeons if they were using the system for the first time?
Dr. Gillespie: The first advice we always talk about is to obtain advanced imaging. This helps for planning your surgery and ensuring you have the proper equipment available.
With this implant specifically, I believe that you don’t have to do quite as much of a soft tissue release posteriorly as we’ve done in the past with onlay glenoids.
Wrapping up, the InSet glenoid has the potential to be disruptive in the field of shoulder surgery. As this continues to get into the hands of other orthopedic surgeons, I’m confident that we’re going to see the same results that we saw in Dr. Gunther and in Dr. Williams’s papers on the InSet Glenoid.