Shoulder Innovations was founded 11 years ago. When all the device companies were focused on their early reverse shoulder designs, an entrepreneurial surgeon and his partners focused on a better glenoid implant design.
I sat down with Dr. Steve Gunther, co-founder to learn the Shoulder Innovations story.
#1 – How did Shoulder Innovations get started? Take us back to the inception of the idea. We would love to hear the backstory.
Shoulder Innovations began as an idea in my head. I performed a 6-hour total shoulder revision surgery in the late 1990s when I was a young faculty member at UCSF/Stanford Healthcare. The previous bone grafted total shoulder, performed 22 years previously, loosened and the loose fixation screws migrated out of the joint. The anterior screw fragment was lost in the anterior soft tissues. After 4 hours of anterior soft tissue dissection, I carefully removed the screw fragment from the axillary sheath, right next to the axillary artery and vein. This was my wake-up call. There must be a better way to perform shoulder replacement surgery on deficient bone without bone grafts and screws!
#2- How was Shoulder Innovations initially created, funded, and staffed?
After I left UCSF, I moved to northern California on the border of wine country and lumber country. I treated lots of manual laborers, millwrights, loggers, truckers, etc… with severe shoulder arthritis and bone loss. So, I designed a new implant and surgical method that could be imprinted in deficient bone like a man-hole cover on the road. My wife and I boot-strapped the company. There was no staff at that time. I wrote my original patent with my cousin, who is a patent attorney. Five years later, I met a venture capitalist (Mike DeVries) at a meeting. After he learned about the inset glenoid, the less invasive surgical approach, and the highly successful early clinical results in bone deficient patients, we joined together and created Shoulder Innovations, LLC. He also brought a brilliant engineer (Des O’Farrell) to help us expand our IP, develop some new concepts, and gain FDA approval for our total shoulder system.
#3 – What does the team look like in 2020?
In 2015, Shoulder Innovations partnered with a world class group of shoulder executives and engineers with extensive senior level industry experience, expertise, and success in the shoulder market. The team at Genesis Innovation (Rob Ball, Jeff Ondrla, Don Running, Matt Ahearn, David Blue) provided the company with decades of executive, R&D, quality, regulatory, sales, and marketing experience from previous senior roles at DePuy/J&J, Tornier, Biomet, DVO, Zimmer, etc… The talent pool has grown even more over the past few years.
#4 – Please describe the benefits of inset technology versus onlay? Why hasn’t a company done this before?
The most important advantage of inset glenoid technology is the dramatically improved fixation strength from the peripheral wall of “containment” around the entire perimeter of the imbedded implant. The bony containment rim provides long-term protection from the typical “rocking horse” forces that tend to loosen classic onlay glenoid implants. This mechanical advantage has been proven in multiple clinical and scientific analyses published in the Journal of Shoulder and Elbow Surgery (2012, 2012, 2016, 2017, 2019) including long term results up to 10 years after surgery. The low depth profile of the implant also allows both version realignment and strong fixation in severely deficient bone. Finally, the surgical method provides a peripheral wall of containment surrounding the implant that protects both the edge of the polyethylene implant from poly wear and protects the bone-cement interface. Classic onlay glenoid implants rely solely on backside keel or peg fixation.
This shows an inset glenoid trial in an SLA shoulder model with deficient bone (blue), inset glenoid (left), and inset augmented glenoid (right)