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.”

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“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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