His last name traces back to the Kentucky frontiersman Daniel Boone, legendary for his wilderness exploits. Given that family history, no wonder Eddie loves spending time in nature.

The career electrician built his Nelson County log home with his bare hands back in the ’70s. If you look closely, you can see Bernheim Forest from his back deck. And, adorning the walls are elk busts and antlers, memories of family hunting and backpacking trips as far west as Alaska.

“It’s always fun to know that [my family] can enjoy the outdoors as well, and I used to say I’ve got to be in shape enough to make the trek,” Eddie said.

In 2019, Eddie and his family drove to Dotsero, Colorado, for a horseback hunting trip. While driving through the mountains, Eddie noticed his left shoulder would seemingly catch when he turned the steering wheel.

“Extensive driving became a problem,” he said. “Maybe [it was] the hills and stuff out there, but I was noticing a little trouble then.”

Then it got worse. Eddie couldn’t saddle his own horse. He knew he had a bigger issue. He was losing hope.

“I was thinking, ‘Something’s got to change,’” Eddie said.

‘My shoulder was completely damaged’

Eddie started conservative treatments on his shoulder.

He began a series of injections, both with and without steroids. He tried dry needling, a physical therapy treatment that involves inserting thin needles. Those treatments worked, but only for a short time.

“I didn’t know my shoulder was completely damaged,” Eddie said. “I’ve had several shots, but … every time I had that, it would only help it for a little while, and then it would get worse.”

Making matters more complicated was the damage in Eddie’s knees, both of which needed to be surgically repaired. He put off the shoulder issue for a little while longer and visited Chad E. Smith, M.D., orthopedic surgeon with Norton Orthopedic Institute. In robotic-assisted surgeries, Dr. Smith repaired both of Eddie’s knees.

Meanwhile, the pain in Eddie’s shoulder only worsened. It affected his everyday life.

“Even though I’m right-handed, you don’t realize how much that left hand assists everything you do,” he said. “And one major thing right now that I notice is just trying to do anything toward your belt — getting your pants on the right way, or even getting them on, period. Putting a shirt on. Brushing your hair. All this is normal stuff that is showing me I’ve got to have my shoulder better than it’s been.”

He was introduced to Justin M. Givens, M.D., shoulder and elbow orthopedic surgeon with Norton Orthopedic Institute, who determined Eddie was a candidate for a reverse shoulder replacement.

“He had a big rotator cuff tear that was unrepairable,” Dr. Givens said. “He had arthritic changes. And so, you have two issues going on that the reverse shoulder replacement was specifically made for. And then you say, ‘OK, is it affecting his life?’ He can’t lift his arm. He’s in terrible pain. He can’t sleep at night. So for me, that’s someone who has an injury we have a fix for and has an issue that’s significantly affecting his life.”

‘We’ve never had this level of accuracy’

Dr. Givens and Eddie discussed the options and determined Eddie was a candidate for an innovative shoulder procedure. Eddie was a candidate for robotic-assisted reverse shoulder replacement.

This new technology is designed to elevate Dr. Givens’ control and confidence by providing him with a 3D image of the patient’s unique shoulder anatomy. Dr. Givens then can study those 3D simulations before surgery and view them on a screen during the procedure. The robotic arm assists him in shaving down the patient’s glenoid (shoulder socket), creating the ideal surface for the implant. From there, the robotic arm’s capabilities help ensure that the implant is positioned within the preplanned boundaries, while aiming for improved accuracy. The goal is to allow for a more natural range of motion and better long-term outcomes for patients.

In March 2025, Dr. Givens became one of the first five surgeons in the country — and the first in Kentucky — to perform this procedure.

“This technology gives me precision to ensure every cut and movement is exactly what the individual patient needs,” Dr. Givens said. “We’ve never had this level of accuracy before in this field. Now, the procedures we’ve theorized can be put into practice. And for me, when I’m talking about trying to give you the best outcome, and I have technology that can get within 0.1 millimeters of precision, it’s a pretty easy decision to make.”

Eddie, who’d had the two robotic-assisted surgeries performed on his knees, knew the benefits of the new technology and agreed to have it done. So on March 19, 2025, Dr. Givens performed the successful robotic-assisted reverse shoulder replacement.

“If there’s a medical procedure to fix this, then I’m all for it,’” Eddie said. “And Dr. Givens came up with this diagnosis that [my shoulder] is completely shot, and told me he’s got a new robotic application. Like I said, I’m ready for it. That’s what it’s all about for me.”

‘Technology needs to be the major push’

In the first two weeks since surgery, Eddie already has seen dramatic improvement. He was out of his sling in just seven days. His range of motion is returning closer to normal by the day.

“This is something that I was not able to do just a few days ago,” Eddie said as he swung his arm around.

Now, Eddie’s goal is to rest up, continue his physical therapy regimen and eventually get back to the outdoors, spending time hiking, hunting and fishing with his family. He also wants others to know there is hope for them too, if they’re experiencing daily pain.

“I hope they can see that there is light at the end of the tunnel as far as your health goes. If you can just stay with it and be lucky enough to run across good surgeons, like Dr. Smith and Dr. Givens. And the technology needs to be the major push, as far as I’m concerned, because of the accuracy, and this is a pretty good show of it.”

The post New robotic-assisted shoulder replacement gives Nelson County man new outlook on life appeared first on Norton Healthcare.

Justin M. Givens, M.D., orthopedic surgeon with Norton Orthopedic Institute, is among the first five surgeons in the country — and the first in Kentucky — to perform a new groundbreaking, robotic-arm assisted reverse shoulder replacement surgery with Mako SmartRobotics. This procedure hopes to offer a higher degree of precision and accuracy compared with traditional methods.

“It’s an honor to be among the first to use this technology,” Dr. Givens said. “This new procedure allows me to give my patients a level of accuracy unlike any other. It’s a more personalized approach to each patient’s needs, which can lead to improved results and faster recovery times.”

The technology is designed to elevate the surgeon’s control and confidence by providing the surgeon with a 3D image of the patient’s unique shoulder anatomy. Dr. Givens can then study the 3D simulations before surgery and view them on a screen during the procedure. The robotic arm assists him in shaving down the patient’s glenoid (shoulder socket), creating the new surface and inserting the implant.

“I still do the approach, meaning I make the incision and move the soft tissue, nerves and veins out of the way,” Dr. Givens said. “But now, the technology helps me to know the movements I’m making are exactly the ones I want to make. This gives us precision to ensure every cut and movement is exactly what the individual patient needs.”

The robotic arm’s capabilities help provide enhanced feedback to ensure the implant is positioned within the preplanned boundaries, while aiming for improved accuracy. The goal is to allow for a more natural range of motion and better long-term outcomes for patients.

“We’ve never had this level of accuracy before in this field,” Dr. Givens said. “Now, the procedures we’ve theorized can be put into practice, and that’s why it’s so exciting to be at the forefront of innovation.”

Reverse shoulder replacement is ideal for patients with severe arthritis, rotator cuff tears or other degenerative shoulder conditions that do not respond to conservative treatments. Furthermore, shoulder arthroplasty (reconstruction or replacement) is the fastest-growing joint arthroplasty in the U.S. According to Dr. Givens, more than 90% of patients are satisfied with their replacements, but doctors are consistently striving for more accuracy and reproducibility to improve that number and help patients achieve a higher level of satisfaction in a shorter amount of time.

Dr. Givens’ orthopedic surgery practice is focused on shoulder and elbow care, including arthroscopy, fracture repair, and joint replacement and revision. In 2024, he performed more than 150 shoulder arthroplasties and anticipates performing more than 200 in 2025.

“My goal is to restore the shoulder to where it’s supposed to be and allow my patients to get back to their normal activities,” Dr. Givens said. “I want my patients to go back to living their normal lives as soon as possible, and this new technology is another tool that will allow them to do so.”

The post Norton Orthopedic Institute surgeon performs new robotic-assisted shoulder replacement appeared first on Norton Healthcare.

Six months ago, Gene could only dream of doing that.

“I couldn’t even go like this,” he said as he reached for the sky. “I had some reservations, but I wanted more mobility and [Dr. Givens] made me feel good. So I went for it.”

‘I’d been in pain for 10 years’

Gene’s whole career has been reliant on his hands.

The former meat cutter and maintenance man is retired now but spent more than 30 years doing manual labor. Among other things, the constant use wore away the cartilage in his shoulders. He developed arthritis and eventually tore the rotator cuff in both shoulders.

He was in pain 24/7.

“I’ve been in pain for 10 years,” he said. “I could barely do anything. It affected me every day. I knew I needed help, so that’s what led me down the path to surgery.”

In 2019, Gene had his right shoulder replaced at a facility in Florida. It was a traditional shoulder replacement, but came with unexpected complications. Gene experienced internal bleeding, requiring a seven-day hospital stay. He continues — five years later — to experience neuropathy down his right arm. It was more than three months following that surgery before he could return to work.

“I still have pain in my right shoulder,” Gene said. “And it made me scared to have my left one done. I knew I needed it, but I put it off for a while just because I didn’t want to repeat what happened during the first one.”

Eventually, the pain in his left shoulder became unbearable. He had to find a solution. His primary care provider referred him to Norton Orthopedic Institute and to Dr. Givens.

“I always tell my patients, ‘I don’t save your life; my job is to make your life better,’” Dr. Givens said. “I want you to leave my office with a better life. And so, that’s the way I approach each patient — how can we get them the best long-term result but without a year of torture in between.”

‘I want you to go out and live your life’

Dr. Givens knew Gene needed surgery.

In addition to his arthritis, Gene had a retroverted left socket, a condition that develops when the shoulder socket, called the glenoid, is abnormally angled in relation to the shoulder blade. A  healthy shoulder has about 5 degrees of retroversion. In Gene’s case, it was 45 degrees, meaning his socket was essentially pointing out the back of his body.

To repair it, Dr. Givens needed to reconstruct Gene’s socket and fully replace his shoulder joint. This procedure would be nothing like the one Gene underwent in 2019.

Dr. Givens specializes in a subscapularis-sparing total shoulder replacement, an innovative surgical technique that aims to minimize damage to the subscapularis muscle, which is responsible for shoulder stability and arm mobility. This technique drastically improves surgical outcomes and reduces recovery time, allowing patients to return to their usual, day-to-day lives quicker.

After the doctor and patient discussed the options, Gene agreed to have the surgery. On April 24, 2024, Dr. Givens performed a successful shoulder replacement, using a 3D model to create a custom implant _— fit perfectly for Gene’s body — to reconstruct his glenoid and reposition his shoulder to its correct position.

“I’m big on getting things as they’re supposed to be and then letting you use them,” Dr. Givens said. “Other surgeons put restrictions on patients — either with lifting or movement — but there’s no data that’s ever supported that with the shoulder.

“We know it’s a mechanical part and, in theory, could wear out. But there’s no data to support that it will, so why are we keeping people from being active, working out and bettering their overall health? I want you to go out and live your life.”

Gene was out of a sling in seven days, which is typical for the method used by Dr. Givens. Gene began physical therapy shortly thereafter. In two weeks, he had 140 degrees of motion. By the six-week mark, he was able to lift his arm straight over his head, a stark contrast from where he was in 2019.

This is why when Gene steps into Dr. Givens’ office for his follow-ups, he smiles. He knows it’s a testament to how far he’s come and how the right doctor can make all the difference.

“I was amazed,” Gene said. “Because the right [shoulder] had so many complications … so when Dr. Givens told me I’d be out of a sling in a week, I said, ‘Are you kidding me?’ But he was right. I think during my first follow-up, I waved at him from down the hall. Every time I’m in [the office] the staff is shocked at how much I can move, how far I bend.”

“This is a team approach,” Dr. Givens said. “And so, that helps us get people seen and get them seen efficiently as well. And that’s the point of orthopedic specialty clinics and why bring these to our community.”

The post Norton Orthopedic Institute surgeon’s shoulder replacement method brings reduced recovery times, better outcomes appeared first on Norton Healthcare.

Training recruits in handcuffing

It was a normal day on the job for this now 54-year-old, but as one of the recruits attempted to handcuff Ken during an exercise, things went sideways.

“I was prone on the ground, and he took my arm straight back over my head,” Ken said.

The sudden sharp pain signaled something was wrong.

The first stop was his primary care provider, who sent Ken to Norton Orthopedic Institute. Doctors told him there were tiny tears — one in the top of the biceps muscle and one in the long head medial tendon, the tough tissue that connects the biceps to the top of the shoulder.

“They looked at me and told me the situation wasn’t to the point I needed surgery,” Ken said. “I was supposed to ice it, take some ibuprofen and do certain stretches.”

He was also advised not to do some things, including headstands and other strenuous activities. He spent a year trying not to overtax the arm and shoulder, trying not to make it worse and trying to let it heal to a certain degree.

Asking a SWAT team leader not to strain a shoulder is like asking a fish not to swim.

Additionally, 2020 was the start of the pandemic, lockdowns and masking, but also a record year for calls to the police department. Ken’s department helps cover other jurisdictions, including providing backup across the river in Louisville, Kentucky.

“I tried to stick with the boundaries they gave me” to protect the shoulder, Ken said. “But then we were called to breach the door of a suspect with a gun.”

The sledgehammering required of Ken reinjured the officer’s shoulder.

“The entire long head medial tendon pulled off the bone,” Ken said.

A pit stop on the road to healing

Surgery was scheduled for October 2021. Ryan J. Krupp, M.D., shoulder surgeon with Norton Orthopedic Institute, led the surgery.

“When you have an injury like this, the tendon shortens, so we can’t just stretch it out to reach the top of the humerus bone where it was,” Dr. Krupp said. “We have to graft some tissue to the end of the biceps and reattach the whole thing to the bone.”

Since it had been a year since the initial injury, there also was a lot of scar tissue built up in the area, so that had to be removed.

After outpatient surgery, Ken was sent home to rest for several weeks before beginning physical therapy. Then his recovery hit a snag.

“I came home from the operation, and I hadn’t eaten for a few days,” Ken said. “I had dinner, and suddenly it felt like I was being stabbed in the gut.”

Back to the hospital he went, this time to the emergency department. Ken was diagnosed with gastrointestinal perforation, or a hole in the lining of the intestine.

“My [primary care] doctor had me taking aspirin as part of the anti-inflammatory course. What we didn’t know is that it was making holes in my intestine,” Ken said.

This time, he was in the hospital for 10 days and underwent surgery to repair the holes. When he was able to start two months of intensive physical therapy for the shoulder, Ken made quick progress.

“They said it was because I was in pretty good shape before the surgery,” Ken said.

Despite a 30-year career, this is only Ken’s second injury on the force, the first being a broken leg. These days, Ken says he’s at about 95% of what he could do before.

“I passed the SWAT physical fitness test when I went back to work, but I don’t have 100% of my range of motion back,” he said.

While there are some slight changes, he’s glad to be back at his law enforcement job and doing great.

The post Indiana sheriff back on the job after shoulder surgery appeared first on Norton Healthcare.

What is the rotator cuff?

The shoulder is a ball (humeral head) and socket (glenoid) joint, which is the most mobile joint in the body. It relies on the soft tissue structures around the shoulder for stability and motion, with the rotator cuff being the most significant of these structures. The rotator cuff is made of four muscles (supraspinatus, infraspinatus, subscapularis and teres minor) and their corresponding tendons that connect the humerus with the shoulder blade to keep the shoulder in place and provide the driving force for motion, such as lifting and rotating the arm.

How can the rotator cuff be damaged?

Rotator cuff tears are common, especially as we age, with most tears occurring in patients over 40. When the muscles are damaged, irritated or torn, patients have pain, weakness and loss of mobility. Injuries like these often occur earlier in people who perform the same overhead motions repeatedly, often being seen in occupations like painters and carpenters. This is also a very common sports injury in “overhead” athletes, such as pitchers who overuse the “pitching arm,” or in weightlifters. Rotator cuff damage can accumulate over time, but tears also can occur after a traumatic event such as a fall or accident. Tears can be partial, where only part of the tendon is damaged, or full, where the tendon is completely separated from the bone.

“In the case of a massive irreparable rotator cuff tear (MIRCT), the tendons have shrunk or pulled back, and thus there is inadequate tissue for a direct repair to the bone even with surgery,” Dr. Krupp said.

Signs of rotator cuff injury and treatments

Pain and tenderness in the affected shoulder are the hallmark signs of rotator cuff injury, including when at rest or lying on the affected arm — especially with reaching overhead, behind the back or when pulling or lifting items. Patients typically experience shoulder weakness and loss of range of motion as well. When caused by trauma, such as lifting or falling on an outstretched arm, there may be sudden acute pain, a snapping sensation and immediate weakness. Symptoms also may develop gradually in more chronic situations, particularly with overhead repetitive activity. A partial or minor rotator cuff tear may get worse over time, especially if you don’t care for it properly.

Nonsurgical treatment may provide some relief of pain and allow for improved function. These treatments include rest and activity modification, strengthening exercises and physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) or steroid injections. If the pain and decreased function persist however, patients should consult with a shoulder specialist.

 New treatment for MIRCT

Fortunately, many rotator cuff tears can be repaired directly to the bone, restoring more normal anatomy and function, especially if addressed in a timely fashion.

“For massive irreparable rotator cuff tears (MIRCT), reverse total shoulder arthroplasty has become the primary treatment in these cases using the deltoid muscle to drive the shoulder and do the work not only of the deltoid but also the damaged rotator cuff,” Dr. Krupp said.

“The reverse total shoulder replacement is a good option for many of our patients, but we are always looking for additional treatments to offer our patients, especially if they do not have much arthritis and are not ready for a shoulder replacement.”

The InSpace balloon implant was designed with this patient population in mind. It allows for the arthroscopic treatment of MIRCT in patients who have the ability to compensate with their remaining rotator cuff and surrounding soft tissue structures and have minimal to no arthritis.  The device is a biodegradable balloon that is inserted between the tip of the shoulder (called the acromion) and the humeral head, and then filled with saline. The balloon creates space between the bones and surrounding tissue, allowing for smoother motion and thus reducing friction and pain.

“It also restores the humeral head to a more normal position, allowing the remaining rotator tissue hopefully to adapt and work to stabilize and drive the shoulder,” Dr. Krupp said.

The implant does not last forever, resorbing over time beginning around three months with complete resorption in six to 12 months.

Per Dr. Krupp, “The theory is that as the implant resorbs, it gets replaced by scar tissue that serves as a buffer between the humeral head and acromion while at the same time allowing the patient to rehab the remaining rotator cuff tissue and other muscles around the shoulder.”

Potential advantages of this procedure compared with alternative treatments for MIRCT include:

• Shorter surgical time
• Less invasive approach
• Quicker return to activity
• Shorter and less complex rehab protocol

The post Rotator cuff surgery approved by FDA and performed in Louisville appeared first on Norton Healthcare.

“I couldn’t throw as hard, and I started throwing weird because of the pain,” the 17-year-old junior said. “I would put my arm over my head and it hurt — a sharp pain in my shoulder.”

The pain in Jack’s shoulder was affecting how well he could play the position he loves — he’s been playing quarterback since he was 7.

“It was pretty hard to deal with,” Jack said. “I knew I should probably get checked out.”

Jack went to see Ryan J. Krupp, M.D., orthopedic surgeon with Norton Orthopedic Institute, who has extensive experience in sports medicine and shoulder reconstruction. Dr. Krupp is also the executive medical director of orthopedics for Norton Sports Health.

To get an accurate picture of the quarterback’s injury, Dr. Krupp had Jack undergo an MR arthrogram, a scan which uses a special dye to get a more detailed image of the inside of a joint. The image showed Jack had an extensive tear in his labrum, a ring of cartilage that reinforces the ball-and-socket joint of the shoulder.

A year ago, Dr. Krupp operated on Jack to reattach the cartilage to bone using anchors and sutures.

The road back with rehab and training

In addition to protecting his arm in a sling, Jack started rehabilitation at KORT located within the Norton Sports Health Performance & Wellness Center, with physical therapist and clinic director Josh Bixler PT, DPT, OCS.

To get ready to play football again, Jack participated in the KORT/Norton Sports Performance Return to Play Program, which uses progressive strengthening and movement to get athletes back in the game. According to Jack, the physical therapy was tiring, but the teen quickly saw results.

“It was night and day from week to week,” Jack said.

He started with basic exercises and worked his way up to throwing, first only 5 yards and then farther and farther away. In time, he was throwing downfield again.

‘I feel brand-new again’

Allison Sivori, Jack’s mother, said she appreciates the patient approach Dr. Krupp and Josh took with her son’s rehabilitation.

“They looked at the big picture. They didn’t try to rush him back. They did it slowly and thoroughly and were thoughtful about bringing him back,” she said. “The communication between Josh and Dr. Krupp was very reassuring. They always had him on the right track.”

To get back in playing shape, the high school quarterback also underwent strength and conditioning training at Norton Sports Performance, with strength coach Brock Martin.

“It feels back to normal now,” Jack said. “Before surgery I was in a lot of pain. I feel brand-new again.”

The post With repaired shoulder, St. X quarterback feels ‘brand-new’ appeared first on Norton Healthcare.

The 65-year-old braced himself with his left arm, tearing the rotator cuff in his shoulder when he hit the ground. After a trip to the emergency room, X-rays, and a magnetic resonance imaging (MRI) scan, Dan learned he needed shoulder surgery. The thought made him nervous — until he met Nyagon G. Duany, M.D., orthopedic surgeon and sports medicine specialist with Norton Orthopedic Institute.

“Dr. Duany is special. She really is a loving, caring person. I sensed the genuineness in her approach to me and the caring spirit she had,” Dan said.

That caring spirit carried over to the entire staff.

Related: Rotator cuff surgery approved by FDA and performed in Louisville

“Everyone from the first ‘hello’ was fantastic and demonstrated a genuine and very evident concern for my well-being,” Dan said. “They were friendly, very inviting, made you feel at ease. They weren’t rushed. I just think the whole office is a reflection of Dr. Duany.”

Appreciating great service

The Louisville native said he’s acutely aware of how people are treated because he’s in customer service himself. He works for a human resources company advising people on how to apply for leaves of absence.

“I try to provide the best customer service I can. It’s nice to be on the receiving end of good customer service,” Dan said. “Customer service is an inexpensive but extremely important part of the doctor-patient experience. I felt it with Dr. Duany, and I’m sure that her other patients also feel it.”

Dan had his accident in May on the Pond Creek Path, part of the Louisville Loop. He had been trying to stay in shape during the pandemic and had reached 13 miles a day when he tore his rotator cuff.

Physical therapy and bike shopping

Dr. Duany repaired the tear surgically in early June, and now Dan is undergoing physical therapy with KORT. He’s improving steadily as he gets his range of motion back. After that, he’s going to work on building up the strength in his shoulder.

Before he went into customer service, Dan was in the ministry, a calling that took him to Cincinnati, Ohio, and elsewhere in Kentucky before he returned to Louisville in 2012. At its heart, he said, a ministry is about caring for people.

“That’s what Dr. Duany does. It’s a ministry to her because she’s caring for people,” Dan said. “It’s more than just a job to her.”

A father of three sons and grandfather of five, Dan said he’s looking forward to getting back on the bicycle. He’s going to find a bike that’s easier to dismount — and he’s not planning to turn around in tall grass anytime soon.

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