Years of overuse had left Gene Lacey’s shoulder nearly unusable. But a visit to Norton Orthopedic Institute introduced him to a procedure that would repair his shoulder and change his life.

Published: December 20, 2024

Gene Lacey’s latest trip to the office of Justin M. Givens, M.D. was more of a formality than an appointment. He was there to show off his progress — to show Dr. Givens the range of motion in his surgically-repaired left shoulder. Needless to say, Gene’s progress has been dramatic, evidenced by his ability to lift his arm straight above his head.

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.”