Making beautiful music

After five years of dealing with shoulder pain, Nancy Mann, a classically trained pianist, thought she’d never get to play her music again.

The pain began after she fell out of a pose in yoga class. After the fall, she had stiffness and pain in her right shoulder and was diagnosed with a frozen shoulder.

Weeks of physical therapy didn’t help, so Mann went to an orthopedic surgeon, who determined she had a torn labrum. The labrum is rubbery tissue that creates a cuplike shape known as the shoulder socket. When it tears, it makes it impossible to have a normal range of motion. Mann had labrum repair surgery and thought she was on the road to recovery.

“I was going gangbusters in physical therapy,” Mann said, “And then all of a sudden, I couldn’t move it. At times, I had to have my husband cut my food for me. Even walking was painful.”

Hope for a remedy

Mann’s orthopaedic surgeon in her hometown of Savannah, Ga., recommended she see Bruce Steinberg, MD, an orthopedic surgeon with Jacksonville Orthopaedic Institute. Dr. Steinberg knew Mann needed a total shoulder replacement, but severe osteoporosis had deteriorated her glenoid, the area where the shoulder socket attaches.

A total shoulder replacement involves removing portions of the shoulder joint and replacing them with artificial implants. “The osteoporosis in Nancy’s shoulder was so severe that there was nothing to connect the implant to,” said Dr. Steinberg.

Mann’s pain had escalated to an 8 or 9 on a scale of 10 and her quality of life was suffering.

She especially missed the piano, which she played at her church and taught for 30 years. “I love to play and consider it my ministry. It brings so much joy to me and to the people I play for, giving them some solace in tough times,” she said.

In search of the best approach

Dr. Steinberg was determined to find a solution for Mann. “I researched options for several months and finally determined that a new technology that could make up for the severe loss of bone by making a custom-made 3D titanium implant.”

Called the Signature ™ Glenoid Shoulder System, the implant is made based on CT imaging of the patient’s shoulder and is 3D-printed to match the patient’s exact anatomy to fill in the missing bone perfectly. The computer-assisted system enables the surgeon to determine the right length and trajectory of the screws that attach the implant to the patient’s natural anatomy. The shoulder joint can then be attached to the implant so the shoulder functions more normally.

“Without this technology, Nancy would still be in pain with very limited activities. The fact that the implant is custom-made provides a natural fit with a good range of motion,” Dr. Steinberg said.

The procedure took Dr. Steinberg about three hours and Mann stayed in the hospital for just two nights. “After 16 weeks of physical therapy, Nancy felt significantly better and was able to return to the activities she loves,” Dr. Steinberg said.

“I have a life now,” Mann said. She’s playing with her young grandchildren again, even going down slides at the local playground. “I walk about three miles a day and soon, I’ll get back to water aerobics.”

Most rewarding, she’s back to playing the piano and enjoys being a bright spot for her listeners. “Dr. Steinberg restored my life,” said Mann. “Being able to play the piano again has given me back my purpose.”

For an appointment at JOI, call 904.564.2000 or visit Jacksonville Orthopaedic Institute