Community Conversation: Stephen B. Gunther, MD with Martha Jefferson Hospital (8-27-24)

AVAILABLE EXCLUSIVELY TO PEOPLE WHO PAY OUT OF POCKET THROUGH AVAILABLE EXCLUSIVELY TO PEOPLE WHO PAY OUT OF POCKET THROUGH LILLYDIRECT. PEOPLE WHO PAY OUT OF POCKET THROUGH LILLYDIRECT. PEOPLE WHO PAY OUT OF POCKET THROUGH LILLYDIRECT. >>>STEVE: PEOPLE WHO PAY OUT OF POCKET THROUGH LILLYDIRECT. >>>STEVE: IN PEOPLE WHO PAY OUT OF POCKET THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S PEOPLE WHO PAY OUT OF POCKET THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S COMMUNITY THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S COMMUNITY THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED THROUGH LILLYDIRECT. >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED BY >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED BY >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED BY doctor >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED BY doctor STEPHEN >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED BY doctor STEPHEN B. >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED BY doctor STEPHEN B. GUNTHER, >>>STEVE: IN TODAY'S COMMUNITY CONVERSATION, WE ARE JOINED BY doctor STEPHEN B. GUNTHER, AN CONVERSATION, WE ARE JOINED BY doctor STEPHEN B. GUNTHER, AN CONVERSATION, WE ARE JOINED BY doctor STEPHEN B. GUNTHER, AN ORTHOPEDIC CONVERSATION, WE ARE JOINED BY doctor STEPHEN B. GUNTHER, AN ORTHOPEDIC SURGEON CONVERSATION, WE ARE JOINED BY doctor STEPHEN B. GUNTHER, AN ORTHOPEDIC SURGEON WITH doctor STEPHEN B. GUNTHER, AN ORTHOPEDIC SURGEON WITH doctor STEPHEN B. GUNTHER, AN ORTHOPEDIC SURGEON WITH SENTARA doctor STEPHEN B. GUNTHER, AN ORTHOPEDIC SURGEON WITH SENTARA MARTHA doctor STEPHEN B. GUNTHER, AN ORTHOPEDIC SURGEON WITH SENTARA MARTHA JEFFERSON ORTHOPEDIC SURGEON WITH SENTARA MARTHA JEFFERSON ORTHOPEDIC SURGEON WITH SENTARA MARTHA JEFFERSON HOSPITAL. ORTHOPEDIC SURGEON WITH SENTARA MARTHA JEFFERSON HOSPITAL. HEY ORTHOPEDIC SURGEON WITH SENTARA MARTHA JEFFERSON HOSPITAL. HEY ERIN. SENTARA MARTHA JEFFERSON HOSPITAL. HEY ERIN. SENTARA MARTHA JEFFERSON HOSPITAL. HEY ERIN. >>>ERIN: SENTARA MARTHA JEFFERSON HOSPITAL. HEY ERIN. >>>ERIN: TALKING SENTARA MARTHA JEFFERSON HOSPITAL. HEY ERIN. >>>ERIN: TALKING ABOUT HOSPITAL. HEY ERIN. >>>ERIN: TALKING ABOUT Say Say quickly, Say quickly, isn't Say quickly, isn't it Say quickly, isn't it right? Say quickly, isn't it right? Yeah, Say quickly, isn't it right? Yeah, it's Say quickly, isn't it right? Yeah, it's a Say quickly, isn't it right? Yeah, it's a mouthful. Say quickly, isn't it right? Yeah, it's a mouthful. So Say quickly, isn't it right? Yeah, it's a mouthful. So most Yeah, it's a mouthful. So most Yeah, it's a mouthful. So most cases Yeah, it's a mouthful. So most cases of Yeah, it's a mouthful. So most cases of shoulder Yeah, it's a mouthful. So most cases of shoulder arthritis Yeah, it's a mouthful. So most cases of shoulder arthritis that cases of shoulder arthritis that cases of shoulder arthritis that need cases of shoulder arthritis that need surgery cases of shoulder arthritis that need surgery are cases of shoulder arthritis that need surgery are osteoarthritis. need surgery are osteoarthritis. need surgery are osteoarthritis. But need surgery are osteoarthritis. But there need surgery are osteoarthritis. But there are need surgery are osteoarthritis. But there are inflammatory But there are inflammatory But there are inflammatory arthritis But there are inflammatory arthritis like But there are inflammatory arthritis like rheumatoid arthritis like rheumatoid arthritis like rheumatoid arthritis arthritis like rheumatoid arthritis and arthritis like rheumatoid arthritis and other arthritis like rheumatoid arthritis and other kinds. arthritis and other kinds. arthritis and other kinds. Psoriatic arthritis and other kinds. Psoriatic arthritis, arthritis and other kinds. Psoriatic arthritis, etc. arthritis and other kinds. Psoriatic arthritis, etc. Then Psoriatic arthritis, etc. Then Psoriatic arthritis, etc. Then there Psoriatic arthritis, etc. Then there are Psoriatic arthritis, etc. Then there are some Psoriatic arthritis, etc. Then there are some fractures Psoriatic arthritis, etc. Then there are some fractures that there are some fractures that there are some fractures that need there are some fractures that need arthroplasty there are some fractures that need arthroplasty surgery, there are some fractures that need arthroplasty surgery, and need arthroplasty surgery, and need arthroplasty surgery, and rarely need arthroplasty surgery, and rarely there need arthroplasty surgery, and rarely there are need arthroplasty surgery, and rarely there are rotator need arthroplasty surgery, and rarely there are rotator cuff rarely there are rotator cuff rarely there are rotator cuff tears rarely there are rotator cuff tears that rarely there are rotator cuff tears that are rarely there are rotator cuff tears that are massive rarely there are rotator cuff tears that are massive and tears that are massive and tears that are massive and retracted. tears that are massive and retracted. And tears that are massive and retracted. And the tears that are massive and retracted. And the head, tears that are massive and retracted. And the head, instead retracted. And the head, instead retracted. And the head, instead of retracted. And the head, instead of being retracted. And the head, instead of being in retracted. And the head, instead of being in the retracted. And the head, instead of being in the right retracted. And the head, instead of being in the right place, of being in the right place, of being in the right place, goes of being in the right place, goes up of being in the right place, goes up and of being in the right place, goes up and down. of being in the right place, goes up and down. So of being in the right place, goes up and down. So we of being in the right place, goes up and down. So we do goes up and down. So we do goes up and down. So we do what's goes up and down. So we do what's called goes up and down. So we do what's called a goes up and down. So we do what's called a reverse goes up and down. So we do what's called a reverse ball goes up and down. So we do what's called a reverse ball and what's called a reverse ball and what's called a reverse ball and socket what's called a reverse ball and socket shoulder what's called a reverse ball and socket shoulder replacement. what's called a reverse ball and socket shoulder replacement. So socket shoulder replacement. So socket shoulder replacement. So two socket shoulder replacement. So two different socket shoulder replacement. So two different types. socket shoulder replacement. So two different types. Okay. socket shoulder replacement. So two different types. Okay. And two different types. Okay. And two different types. Okay. And those two different types. Okay. And those are two different types. Okay. And those are the two different types. Okay. And those are the two two different types. Okay. And those are the two main two different types. Okay. And those are the two main types. those are the two main types. those are the two main types. Yes. those are the two main types. Yes. Okay those are the two main types. Yes. Okay Gotcha. those are the two main types. Yes. Okay Gotcha. And those are the two main types. Yes. Okay Gotcha. And can those are the two main types. Yes. Okay Gotcha. And can you Yes. Okay Gotcha. And can you Yes. Okay Gotcha. And can you walk Yes. Okay Gotcha. And can you walk us Yes. Okay Gotcha. And can you walk us through Yes. Okay Gotcha. And can you walk us through what Yes. Okay Gotcha. And can you walk us through what patients walk us through what patients walk us through what patients can walk us through what patients can expect walk us through what patients can expect during walk us through what patients can expect during shoulder can expect during shoulder can expect during shoulder replacement can expect during shoulder replacement surgery? can expect during shoulder replacement surgery? The can expect during shoulder replacement surgery? The whole replacement surgery? The whole replacement surgery? The whole process replacement surgery? The whole process from replacement surgery? The whole process from preparation replacement surgery? The whole process from preparation to process from preparation to process from preparation to recovery. process from preparation to recovery. Sure. process from preparation to recovery. Sure. So process from preparation to recovery. Sure. So the process from preparation to recovery. Sure. So the first process from preparation to recovery. Sure. So the first is recovery. Sure. So the first is recovery. Sure. So the first is their recovery. Sure. So the first is their visit recovery. Sure. So the first is their visit to recovery. Sure. So the first is their visit to us recovery. Sure. So the first is their visit to us in recovery. Sure. So the first is their visit to us in clinic. recovery. Sure. So the first is their visit to us in clinic. So their visit to us in clinic. So their visit to us in clinic. So they their visit to us in clinic. So they expect their visit to us in clinic. So they expect to their visit to us in clinic. So they expect to come their visit to us in clinic. So they expect to come see their visit to us in clinic. So they expect to come see us their visit to us in clinic. So they expect to come see us and they expect to come see us and they expect to come see us and we they expect to come see us and we diagnose they expect to come see us and we diagnose what they expect to come see us and we diagnose what their they expect to come see us and we diagnose what their problem we diagnose what their problem we diagnose what their problem is. we diagnose what their problem is. We we diagnose what their problem is. We ask we diagnose what their problem is. We ask them we diagnose what their problem is. We ask them lots we diagnose what their problem is. We ask them lots of is. We ask them lots of is. We ask them lots of questions is. We ask them lots of questions and is. We ask them lots of questions and see is. We ask them lots of questions and see what is. We ask them lots of questions and see what their questions and see what their questions and see what their needs questions and see what their needs are. questions and see what their needs are. So questions and see what their needs are. So it questions and see what their needs are. So it might questions and see what their needs are. So it might be needs are. So it might be needs are. So it might be stiffness. needs are. So it might be stiffness. It needs are. So it might be stiffness. It might needs are. So it might be stiffness. It might be needs are. So it might be stiffness. It might be pain. stiffness. It might be pain. stiffness. It might be pain. Sometimes stiffness. It might be pain. Sometimes it's stiffness. It might be pain. Sometimes it's instability. stiffness. It might be pain. Sometimes it's instability. It Sometimes it's instability. It Sometimes it's instability. It might Sometimes it's instability. It might be Sometimes it's instability. It might be combination Sometimes it's instability. It might be combination of Sometimes it's instability. It might be combination of all might be combination of all might be combination of all those might be combination of all those things. might be combination of all those things. We might be combination of all those things. We take might be combination of all those things. We take X-rays, those things. We take X-rays, those things. We take X-rays, see those things. We take X-rays, see if those things. We take X-rays, see if they those things. We take X-rays, see if they have those things. We take X-rays, see if they have arthritis. see if they have arthritis. see if they have arthritis. Sometimes see if they have arthritis. Sometimes an see if they have arthritis. Sometimes an MRI see if they have arthritis. Sometimes an MRI scan see if they have arthritis. Sometimes an MRI scan or see if they have arthritis. Sometimes an MRI scan or a see if they have arthritis. Sometimes an MRI scan or a CT Sometimes an MRI scan or a CT Sometimes an MRI scan or a CT scan. Sometimes an MRI scan or a CT scan. The Sometimes an MRI scan or a CT scan. The MRI Sometimes an MRI scan or a CT scan. The MRI shows Sometimes an MRI scan or a CT scan. The MRI shows us Sometimes an MRI scan or a CT scan. The MRI shows us if Sometimes an MRI scan or a CT scan. The MRI shows us if the scan. The MRI shows us if the scan. The MRI shows us if the rotator scan. The MRI shows us if the rotator cuff scan. The MRI shows us if the rotator cuff is scan. The MRI shows us if the rotator cuff is torn. scan. The MRI shows us if the rotator cuff is torn. The scan. The MRI shows us if the rotator cuff is torn. The CT rotator cuff is torn. The CT rotator cuff is torn. The CT shows rotator cuff is torn. The CT shows us rotator cuff is torn. The CT shows us the rotator cuff is torn. The CT shows us the bone rotator cuff is torn. The CT shows us the bone really rotator cuff is torn. The CT shows us the bone really well rotator cuff is torn. The CT shows us the bone really well on shows us the bone really well on shows us the bone really well on imaging, shows us the bone really well on imaging, so shows us the bone really well on imaging, so we shows us the bone really well on imaging, so we can shows us the bone really well on imaging, so we can see shows us the bone really well on imaging, so we can see if imaging, so we can see if imaging, so we can see if there's imaging, so we can see if there's any imaging, so we can see if there's any subtle imaging, so we can see if there's any subtle bone imaging, so we can see if there's any subtle bone loss. imaging, so we can see if there's any subtle bone loss. So there's any subtle bone loss. So there's any subtle bone loss. So we there's any subtle bone loss. So we get there's any subtle bone loss. So we get 3D there's any subtle bone loss. So we get 3D CT there's any subtle bone loss. So we get 3D CT images there's any subtle bone loss. So we get 3D CT images and there's any subtle bone loss. So we get 3D CT images and map we get 3D CT images and map we get 3D CT images and map that. we get 3D CT images and map that. So we get 3D CT images and map that. So when we get 3D CT images and map that. So when we're we get 3D CT images and map that. So when we're doing that. So when we're doing that. So when we're doing surgery that. So when we're doing surgery we that. So when we're doing surgery we can that. So when we're doing surgery we can see that. So when we're doing surgery we can see everything that. So when we're doing surgery we can see everything in surgery we can see everything in surgery we can see everything in 3D. surgery we can see everything in 3D. Oh surgery we can see everything in 3D. Oh wow, surgery we can see everything in 3D. Oh wow, that surgery we can see everything in 3D. Oh wow, that sounds surgery we can see everything in 3D. Oh wow, that sounds pretty 3D. Oh wow, that sounds pretty 3D. Oh wow, that sounds pretty advanced. 3D. Oh wow, that sounds pretty advanced. Yes 3D. Oh wow, that sounds pretty advanced. Yes it 3D. Oh wow, that sounds pretty advanced. Yes it is. 3D. Oh wow, that sounds pretty advanced. Yes it is. Yep. 3D. Oh wow, that sounds pretty advanced. Yes it is. Yep. And 3D. Oh wow, that sounds pretty advanced. Yes it is. Yep. And we advanced. Yes it is. Yep. And we advanced. Yes it is. Yep. And we can advanced. Yes it is. Yep. And we can put advanced. Yes it is. Yep. And we can put it advanced. Yes it is. Yep. And we can put it into advanced. Yes it is. Yep. And we can put it into a advanced. Yes it is. Yep. And we can put it into a software can put it into a software can put it into a software package can put it into a software package too, can put it into a software package too, so can put it into a software package too, so we can put it into a software package too, so we can can put it into a software package too, so we can actually package too, so we can actually package too, so we can actually model package too, so we can actually model that package too, so we can actually model that before package too, so we can actually model that before surgery. package too, so we can actually model that before surgery. Wow. model that before surgery. Wow. model that before surgery. Wow. And model that before surgery. Wow. And then model that before surgery. Wow. And then of model that before surgery. Wow. And then of course model that before surgery. Wow. And then of course we model that before surgery. Wow. And then of course we would And then of course we would And then of course we would discuss And then of course we would discuss the And then of course we would discuss the risks And then of course we would discuss the risks and And then of course we would discuss the risks and benefits discuss the risks and benefits discuss the risks and benefits and discuss the risks and benefits and whether discuss the risks and benefits and whether or discuss the risks and benefits and whether or not discuss the risks and benefits and whether or not they discuss the risks and benefits and whether or not they want and whether or not they want and whether or not they want surgery. and whether or not they want surgery. And and whether or not they want surgery. And then and whether or not they want surgery. And then the and whether or not they want surgery. And then the timing, surgery. And then the timing, surgery. And then the timing, does surgery. And then the timing, does it surgery. And then the timing, does it work surgery. And then the timing, does it work for surgery. And then the timing, does it work for them surgery. And then the timing, does it work for them for surgery. And then the timing, does it work for them for their does it work for them for their does it work for them for their life. does it work for them for their life. Some does it work for them for their life. Some people does it work for them for their life. Some people want does it work for them for their life. Some people want to does it work for them for their life. Some people want to wait life. Some people want to wait life. Some people want to wait till life. Some people want to wait till mowing life. Some people want to wait till mowing season life. Some people want to wait till mowing season is life. Some people want to wait till mowing season is over, life. Some people want to wait till mowing season is over, some till mowing season is over, some till mowing season is over, some people till mowing season is over, some people want till mowing season is over, some people want it till mowing season is over, some people want it during till mowing season is over, some people want it during the people want it during the people want it during the winter, people want it during the winter, etc. people want it during the winter, etc. so people want it during the winter, etc. so we people want it during the winter, etc. so we try people want it during the winter, etc. so we try to people want it during the winter, etc. so we try to match winter, etc. so we try to match winter, etc. so we try to match as winter, etc. so we try to match as well winter, etc. so we try to match as well as winter, etc. so we try to match as well as we winter, etc. so we try to match as well as we can. winter, etc. so we try to match as well as we can. The winter, etc. so we try to match as well as we can. The surgery as well as we can. The surgery as well as we can. The surgery with as well as we can. The surgery with the as well as we can. The surgery with the patient as well as we can. The surgery with the patient and as well as we can. The surgery with the patient and the as well as we can. The surgery with the patient and the timing, with the patient and the timing, with the patient and the timing, etc. with the patient and the timing, etc. And with the patient and the timing, etc. And speaking with the patient and the timing, etc. And speaking of with the patient and the timing, etc. And speaking of timing, etc. And speaking of timing, etc. And speaking of timing, what etc. And speaking of timing, what is etc. And speaking of timing, what is how etc. And speaking of timing, what is how long etc. And speaking of timing, what is how long is etc. And speaking of timing, what is how long is a etc. And speaking of timing, what is how long is a typical what is how long is a typical what is how long is a typical recovery what is how long is a typical recovery time? what is how long is a typical recovery time? Typical what is how long is a typical recovery time? Typical recovery recovery time? Typical recovery recovery time? Typical recovery is, recovery time? Typical recovery is, it recovery time? Typical recovery is, it used recovery time? Typical recovery is, it used to recovery time? Typical recovery is, it used to be recovery time? Typical recovery is, it used to be two recovery time? Typical recovery is, it used to be two days recovery time? Typical recovery is, it used to be two days in is, it used to be two days in is, it used to be two days in hospital is, it used to be two days in hospital when is, it used to be two days in hospital when I is, it used to be two days in hospital when I was is, it used to be two days in hospital when I was teaching is, it used to be two days in hospital when I was teaching at hospital when I was teaching at hospital when I was teaching at UCSF hospital when I was teaching at UCSF Stanford hospital when I was teaching at UCSF Stanford years hospital when I was teaching at UCSF Stanford years ago, hospital when I was teaching at UCSF Stanford years ago, and UCSF Stanford years ago, and UCSF Stanford years ago, and then UCSF Stanford years ago, and then it's UCSF Stanford years ago, and then it's been UCSF Stanford years ago, and then it's been more UCSF Stanford years ago, and then it's been more like UCSF Stanford years ago, and then it's been more like one then it's been more like one then it's been more like one day. then it's been more like one day. And then it's been more like one day. And now then it's been more like one day. And now we then it's been more like one day. And now we discharge then it's been more like one day. And now we discharge a then it's been more like one day. And now we discharge a lot day. And now we discharge a lot day. And now we discharge a lot of day. And now we discharge a lot of people day. And now we discharge a lot of people the day. And now we discharge a lot of people the same day. And now we discharge a lot of people the same day. day. And now we discharge a lot of people the same day. So of people the same day. So of people the same day. So they're of people the same day. So they're in of people the same day. So they're in a of people the same day. So they're in a sling. of people the same day. So they're in a sling. We of people the same day. So they're in a sling. We do of people the same day. So they're in a sling. We do a they're in a sling. We do a they're in a sling. We do a nerve they're in a sling. We do a nerve block they're in a sling. We do a nerve block before they're in a sling. We do a nerve block before surgery, nerve block before surgery, nerve block before surgery, which nerve block before surgery, which works nerve block before surgery, which works quite nerve block before surgery, which works quite well nerve block before surgery, which works quite well for nerve block before surgery, which works quite well for pain which works quite well for pain which works quite well for pain after which works quite well for pain after surgery. which works quite well for pain after surgery. They're which works quite well for pain after surgery. They're in which works quite well for pain after surgery. They're in six after surgery. They're in six after surgery. They're in six weeks. after surgery. They're in six weeks. But after surgery. They're in six weeks. But starting after surgery. They're in six weeks. But starting PT, after surgery. They're in six weeks. But starting PT, physical weeks. But starting PT, physical weeks. But starting PT, physical therapy weeks. But starting PT, physical therapy and weeks. But starting PT, physical therapy and gentle weeks. But starting PT, physical therapy and gentle motion therapy and gentle motion therapy and gentle motion exercises therapy and gentle motion exercises right therapy and gentle motion exercises right off therapy and gentle motion exercises right off the therapy and gentle motion exercises right off the bat. therapy and gentle motion exercises right off the bat. And exercises right off the bat. And exercises right off the bat. And then exercises right off the bat. And then they're exercises right off the bat. And then they're out exercises right off the bat. And then they're out of exercises right off the bat. And then they're out of the exercises right off the bat. And then they're out of the sling exercises right off the bat. And then they're out of the sling at then they're out of the sling at then they're out of the sling at six then they're out of the sling at six weeks then they're out of the sling at six weeks and then they're out of the sling at six weeks and they're then they're out of the sling at six weeks and they're doing then they're out of the sling at six weeks and they're doing some six weeks and they're doing some six weeks and they're doing some gentle six weeks and they're doing some gentle motion. six weeks and they're doing some gentle motion. But six weeks and they're doing some gentle motion. But protecting gentle motion. But protecting gentle motion. But protecting their gentle motion. But protecting their rotator gentle motion. But protecting their rotator cuff gentle motion. But protecting their rotator cuff repair. gentle motion. But protecting their rotator cuff repair. Most their rotator cuff repair. Most their rotator cuff repair. Most patients their rotator cuff repair. Most patients like their rotator cuff repair. Most patients like I their rotator cuff repair. Most patients like I saw their rotator cuff repair. Most patients like I saw two their rotator cuff repair. Most patients like I saw two today patients like I saw two today patients like I saw two today from patients like I saw two today from last patients like I saw two today from last week, patients like I saw two today from last week, don't patients like I saw two today from last week, don't have from last week, don't have from last week, don't have hardly from last week, don't have hardly any from last week, don't have hardly any pain. from last week, don't have hardly any pain. One from last week, don't have hardly any pain. One week from last week, don't have hardly any pain. One week after hardly any pain. One week after hardly any pain. One week after surgery. hardly any pain. One week after surgery. So hardly any pain. One week after surgery. So really hardly any pain. One week after surgery. So really it's hardly any pain. One week after surgery. So really it's just surgery. So really it's just surgery. So really it's just abiding surgery. So really it's just abiding by surgery. So really it's just abiding by the surgery. So really it's just abiding by the precautions surgery. So really it's just abiding by the precautions and abiding by the precautions and abiding by the precautions and slowly, abiding by the precautions and slowly, progressively abiding by the precautions and slowly, progressively doing slowly, progressively doing slowly, progressively doing physical slowly, progressively doing physical therapy. slowly, progressively doing physical therapy. So slowly, progressively doing physical therapy. So they slowly, progressively doing physical therapy. So they build physical therapy. So they build physical therapy. So they build strength, physical therapy. So they build strength, motion physical therapy. So they build strength, motion and physical therapy. So they build strength, motion and function strength, motion and function strength, motion and function without strength, motion and function without tearing strength, motion and function without tearing their strength, motion and function without tearing their rotator without tearing their rotator without tearing their rotator cuff, without tearing their rotator cuff, which without tearing their rotator cuff, which is without tearing their rotator cuff, which is sometimes without tearing their rotator cuff, which is sometimes a without tearing their rotator cuff, which is sometimes a fine cuff, which is sometimes a fine cuff, which is sometimes a fine balance. cuff, which is sometimes a fine balance. Got cuff, which is sometimes a fine balance. Got it. cuff, which is sometimes a fine balance. Got it. Okay. cuff, which is sometimes a fine balance. Got it. Okay. And cuff, which is sometimes a fine balance. Got it. Okay. And how balance. Got it. Okay. And how balance. Got it. Okay. And how does balance. Got it. Okay. And how does shoulder balance. Got it. Okay. And how does shoulder replacement does shoulder replacement does shoulder replacement surgery does shoulder replacement surgery improve does shoulder replacement surgery improve a does shoulder replacement surgery improve a patient's surgery improve a patient's surgery improve a patient's quality surgery improve a patient's quality of surgery improve a patient's quality of life? surgery improve a patient's quality of life? Two surgery improve a patient's quality of life? Two major quality of life? Two major quality of life? Two major things. quality of life? Two major things. One quality of life? Two major things. One is quality of life? Two major things. One is taking quality of life? Two major things. One is taking away quality of life? Two major things. One is taking away their things. One is taking away their things. One is taking away their pain things. One is taking away their pain and things. One is taking away their pain and then things. One is taking away their pain and then second things. One is taking away their pain and then second is pain and then second is pain and then second is improving pain and then second is improving their pain and then second is improving their function. pain and then second is improving their function. And improving their function. And improving their function. And that improving their function. And that can improving their function. And that can be improving their function. And that can be through improving their function. And that can be through motion improving their function. And that can be through motion and that can be through motion and that can be through motion and pain that can be through motion and pain relief. that can be through motion and pain relief. And that can be through motion and pain relief. And a that can be through motion and pain relief. And a lot that can be through motion and pain relief. And a lot of pain relief. And a lot of pain relief. And a lot of patients pain relief. And a lot of patients can pain relief. And a lot of patients can only pain relief. And a lot of patients can only move pain relief. And a lot of patients can only move their patients can only move their patients can only move their shoulders patients can only move their shoulders like patients can only move their shoulders like this. patients can only move their shoulders like this. And patients can only move their shoulders like this. And their shoulders like this. And their shoulders like this. And their shoulder shoulders like this. And their shoulder ratchets shoulders like this. And their shoulder ratchets because shoulders like this. And their shoulder ratchets because it's shoulder ratchets because it's shoulder ratchets because it's like shoulder ratchets because it's like a shoulder ratchets because it's like a it's shoulder ratchets because it's like a it's like shoulder ratchets because it's like a it's like a, shoulder ratchets because it's like a it's like a, a shoulder ratchets because it's like a it's like a, a truck shoulder ratchets because it's like a it's like a, a truck tire like a it's like a, a truck tire like a it's like a, a truck tire with like a it's like a, a truck tire with a like a it's like a, a truck tire with a threads like a it's like a, a truck tire with a threads are, like a it's like a, a truck tire with a threads are, you like a it's like a, a truck tire with a threads are, you know, with a threads are, you know, with a threads are, you know, flying with a threads are, you know, flying off with a threads are, you know, flying off on with a threads are, you know, flying off on the, with a threads are, you know, flying off on the, on with a threads are, you know, flying off on the, on the flying off on the, on the flying off on the, on the highway. flying off on the, on the highway. So, flying off on the, on the highway. So, so flying off on the, on the highway. So, so they flying off on the, on the highway. So, so they go flying off on the, on the highway. So, so they go bum flying off on the, on the highway. So, so they go bum bum highway. So, so they go bum bum highway. So, so they go bum bum bum highway. So, so they go bum bum bum bum highway. So, so they go bum bum bum bum bum. highway. So, so they go bum bum bum bum bum. And highway. So, so they go bum bum bum bum bum. And when highway. So, so they go bum bum bum bum bum. And when they highway. So, so they go bum bum bum bum bum. And when they have bum bum bum. And when they have bum bum bum. And when they have nice bum bum bum. And when they have nice and bum bum bum. And when they have nice and smooth bum bum bum. And when they have nice and smooth motion bum bum bum. And when they have nice and smooth motion after nice and smooth motion after nice and smooth motion after surgery, nice and smooth motion after surgery, they nice and smooth motion after surgery, they don't nice and smooth motion after surgery, they don't hurt nice and smooth motion after surgery, they don't hurt that surgery, they don't hurt that surgery, they don't hurt that that surgery, they don't hurt that that is surgery, they don't hurt that that is an surgery, they don't hurt that that is an amazing surgery, they don't hurt that that is an amazing help surgery, they don't hurt that that is an amazing help to surgery, they don't hurt that that is an amazing help to them. that is an amazing help to them. that is an amazing help to them. So that is an amazing help to them. So then that is an amazing help to them. So then they that is an amazing help to them. So then they can that is an amazing help to them. So then they can also that is an amazing help to them. So then they can also improve So then they can also improve So then they can also improve their So then they can also improve their function. So then they can also improve their function. Very So then they can also improve their function. Very nice. So then they can also improve their function. Very nice. Well their function. Very nice. Well their function. Very nice. Well that's their function. Very nice. Well that's all their function. Very nice. Well that's all the their function. Very nice. Well that's all the questions their function. Very nice. Well that's all the questions I their function. Very nice. Well that's all the questions I have. that's all the questions I have. that's all the questions I have. Do that's all the questions I have. Do you that's all the questions I have. Do you have that's all the questions I have. Do you have anything that's all the questions I have. Do you have anything you that's all the questions I have. Do you have anything you want that's all the questions I have. Do you have anything you want to Do you have anything you want to Do you have anything you want to add? Do you have anything you want to add? Yeah. Do you have anything you want to add? Yeah. One Do you have anything you want to add? Yeah. One one Do you have anything you want to add? Yeah. One one thing Do you have anything you want to add? Yeah. One one thing is Do you have anything you want to add? Yeah. One one thing is to add? Yeah. One one thing is to add? Yeah. One one thing is to just add? Yeah. One one thing is to just add add? Yeah. One one thing is to just add that add? Yeah. One one thing is to just add that a add? Yeah. One one thing is to just add that a lot add? Yeah. One one thing is to just add that a lot of add? Yeah. One one thing is to just add that a lot of people just add that a lot of people just add that a lot of people have just add that a lot of people have the just add that a lot of people have the misconception just add that a lot of people have the misconception that have the misconception that have the misconception that shoulder have the misconception that shoulder surgery, have the misconception that shoulder surgery, unlike have the misconception that shoulder surgery, unlike hip have the misconception that shoulder surgery, unlike hip and shoulder surgery, unlike hip and shoulder surgery, unlike hip and knee shoulder surgery, unlike hip and knee surgery, shoulder surgery, unlike hip and knee surgery, is shoulder surgery, unlike hip and knee surgery, is more shoulder surgery, unlike hip and knee surgery, is more back shoulder surgery, unlike hip and knee surgery, is more back in knee surgery, is more back in knee surgery, is more back in the knee surgery, is more back in the dark knee surgery, is more back in the dark ages knee surgery, is more back in the dark ages and knee surgery, is more back in the dark ages and not knee surgery, is more back in the dark ages and not as knee surgery, is more back in the dark ages and not as good the dark ages and not as good the dark ages and not as good yet. the dark ages and not as good yet. That's the dark ages and not as good yet. That's really the dark ages and not as good yet. That's really not the dark ages and not as good yet. That's really not true. the dark ages and not as good yet. That's really not true. The yet. That's really not true. The yet. That's really not true. The nerve yet. That's really not true. The nerve blocks yet. That's really not true. The nerve blocks work yet. That's really not true. The nerve blocks work really yet. That's really not true. The nerve blocks work really well. nerve blocks work really well. nerve blocks work really well. Our nerve blocks work really well. Our implants nerve blocks work really well. Our implants have nerve blocks work really well. Our implants have been nerve blocks work really well. Our implants have been developed Our implants have been developed Our implants have been developed over Our implants have been developed over the Our implants have been developed over the last Our implants have been developed over the last 15 Our implants have been developed over the last 15 years, Our implants have been developed over the last 15 years, are Our implants have been developed over the last 15 years, are much over the last 15 years, are much over the last 15 years, are much better. over the last 15 years, are much better. Patients over the last 15 years, are much better. Patients do better. Patients do better. Patients do exceptionally better. Patients do exceptionally well better. Patients do exceptionally well and better. Patients do exceptionally well and I exceptionally well and I exceptionally well and I actually exceptionally well and I actually invented exceptionally well and I actually invented a exceptionally well and I actually invented a few exceptionally well and I actually invented a few implants actually invented a few implants actually invented a few implants that actually invented a few implants that have actually invented a few implants that have better actually invented a few implants that have better fixation actually invented a few implants that have better fixation than that have better fixation than that have better fixation than the that have better fixation than the previous that have better fixation than the previous implants. that have better fixation than the previous implants. So that have better fixation than the previous implants. So we're the previous implants. So we're the previous implants. So we're getting the previous implants. So we're getting better the previous implants. So we're getting better and the previous implants. So we're getting better and better the previous implants. So we're getting better and better every getting better and better every getting better and better every 5 getting better and better every 5 to getting better and better every 5 to 10 getting better and better every 5 to 10 years. getting better and better every 5 to 10 years. But getting better and better every 5 to 10 years. But they're 5 to 10 years. But they're 5 to 10 years. But they're they're 5 to 10 years. But they're they're 98% 5 to 10 years. But they're they're 98% right 5 to 10 years. But they're they're 98% right now. 5 to 10 years. But they're they're 98% right now. So. 5 to 10 years. But they're they're 98% right now. So. Wow. they're 98% right now. So. Wow. they're 98% right now. So. Wow. Yeah. they're 98% right now. So. Wow. Yeah. They're they're 98% right now. So. Wow. Yeah. They're just they're 98% right now. So. Wow. Yeah. They're just as they're 98% right now. So. Wow. Yeah. They're just as successful Yeah. They're just as successful Yeah. They're just as successful as Yeah. They're just as successful as hips Yeah. They're just as successful as hips and Yeah. They're just as successful as hips and knees, Yeah. They're just as successful as hips and knees, which Yeah. They're just as successful as hips and knees, which have as hips and knees, which have as hips and knees, which have been as hips and knees, which have been done as hips and knees, which have been done for as hips and knees, which have been done for a as hips and knees, which have been done for a long as hips and knees, which have been done for a long time. been done for a long time. been done for a long time. Right. been done for a long time. Right. Very