Future Hall of Fame athlete Curt Schilling is the only pitcher in major league history to complete a World Series game as a 20 year old, a 30 year old and a 40 year old. Brett Favre, another future Hall of Fame athlete, has the most career victories as a starting quarterback in the history of the NFL and at age 40 took the Minnesota Vikings to an NFC championship game. What do these two remarkable athletes have in common? Astonishing shoulder durability…and Dr. Anthony Romeo.
Or perhaps more specifically, Dr. Romeo’s innovative approach to tears of the labrum, which includes sewing down the tear in the superior labrum and taking the biceps tendon out of the shoulder joint. When Dr. Romeo first tried this approach many years ago it represented a direct challenge to the conventional wisdom that all superior labral lesions needed to be fixed. Curt Schilling and Brett Favre are just two notable examples of the thousands of people who’ve benefited from Dr. Romeo’s brilliant, focused and persistent mind.
Today, as a full Professor of Orthopaedics at Rush University Medical Center, a team physician for the Chicago Bulls and the Chicago White Sox, as well as design surgeon for two widely used shoulder replacement systems, Dr. Anthony Romeo is recognized for the profound effect he has had on U.S. professional athletics and on the standard of care for shoulder repair. As a result, Dr. Romeo is this week’s Picture of Success.
Dr. Romeo’s training began by tagging along behind his dad on many 2AM trips to the ER when his father was a physician in the U.S. Navy, then later as a family physician in a small Idaho community.
“I spent most of my youth in a small town Idaho, where my five siblings and I often trailed along behind my dad. My mom kept us all moving forward in the right direction; I was born when my parents were seniors in college, so my mother had to give up her educational dreams for me and her family; she was especially focused on our education. I didn’t disappoint her, as I was the valedictorian (in addition to being captain of the football team).”
While Anthony Romeo was inspired by those “field trips” to the ER, and his mother’s devotion to education, his early interests were broad. “My parents have said that I was always determined to exceed whatever boundaries stood in front of me, and that I wanted to explore everything (choir, art, etc.). Nothing drew me in like medicine, however. It sounds cliché, but I could see that giving of myself to patients would be a rewarding way to spend my life.”
After completing his undergraduate studies at Notre Dame, Anthony Romeo entered his father’s alma mater for medical school: St. Louis University (SLU). “Because I played football at Notre Dame my grades suffered a bit. I was one of the last students accepted to SLU, but I worked hard and graduated in the top 5% of the class.”
Then he heard the voices…the naysayers, that is. “You want to go to Cleveland Clinic for residency? Students from SLU can’t get into their program.” Dr. Romeo: “I tuned these people out, pressed on, and was accepted into the Cleveland Clinic program. There I encountered a few other cynics who said, ‘Rick Matsen’s fellowship in Seattle? Good luck. No one from here has ever been accepted into his program.’”
So when he arrived on Dr. Matsen’s Seattle doorstep, the unrelenting Dr. Romeo had accomplished something indeed. “I was thrilled to be acquiring such high level training in shoulder, which had become my passion. I had injured my shoulder while playing football at Notre Dame and was struck by the real lack of knowledge about shoulder. The treating orthopedist just said, ‘Put some ice on it.’ I had found something that merited further investigation! By the time I reached my fellowship, I was thoroughly consumed with discovering all I could about the shoulder.”
A trailblazer, Dr. Romeo took his knowledge and improved upon current practices. “Dr. Matsen and his partner, the late Dr. Harryman, taught me the principles of shoulder surgery, namely, the unchanging rules of how the shoulder works and how to treat it with current open or developing arthroscopic techniques (when most shoulder surgeons were doing open procedures). When I went into practice most surgeons were just beginning to attempt surgeries with an arthroscope, which has its limitations. They were actually changing the way they were treating the shoulder just so they could do the surgery arthroscopically.”
My approach was to alter the existing tools and instruments to match the principles of shoulder surgery. This principle-based approach turned out so well that I am routinely approached by U.S. and foreign training facilities to teach my methods.
And when he does have an audience, jaws often drop.
“I have the uncanny ability to focus on the surgical procedure at hand while also talking about what I am doing. For example, I recently performed a surgery in Vienna that was broadcast to 700 surgeons, along with a moderator. All the while I was answering questions about what I was doing. I’ve had people say to me, ‘It’s like you have two brains, one for lecturing and one for the procedure.’ I tell them, ‘It’s just like with a professional athlete…they don’t know how to explain it—it just happens.’”
While he cannot teach residents and fellows that particular talent, he can offer them extraordinary knowledge, coupled with some hard won life lessons. “I really emphasize to my trainees the importance of listening to patients, saying, ‘The patients themselves will tell you what is wrong with their shoulders.’ I focus on a thorough history and physical exam and tell them that as they learn their specialty they will be able to understand 90% of what comes in the door with just the history and examination, supported by plain radiographs. The goal is not to manage what you see but to take care of the problem the patient came in for. If you are staring at a problematic rotator cuff, but the patient is complaining of shoulder slippage, then you must investigate further.”
“On a more personal level, I try to get trainees to understand the necessity of living a balanced life. In this profession we have many wonderful opportunities to help people, as well as, frankly, opportunities to feed our egos.”
The problem is often that we forget about the other parts of our lives. In the long run our ability to sustain that which gives us these rewards is what we do outside of our practice. If you fail to work on your personal life then your professional life will suffer and you won’t reach the heights you desire.
“I have five daughters and was married at 22 years old. While I worked hard to be a good surgeon and dad, and thought I was being a good partner, I was often busy and for a variety of reasons the marriage didn’t last. For seven years now I have been raising my five teenage daughters by myself. This is a wonderful blessing, but the challenges can be overwhelming without the support of family and friends. ‘Remember, ’ I tell young surgeons, ‘the bright lights and patient admiration is seductive, but we must balance this out with our personal lives.’”
When it is work time, however, Dr. Romeo is exceptionally focused. And if Mrs. Jones has a problem he can’t solve…he takes it to the lab. “Whenever I have a patient with a problem that I don’t understand, I ‘sit with it.’ Then, after awhile, in come a few more people with the same problem…then we go to the lab, study it, and then apply the findings to clinical practice.”
“For example, almost twenty years ago I learned how to treat superior labral tears from the people who first described them in the literature. I found that even though I could perform the operation as well as they could, I couldn’t get the same results. My colleagues and I found that there are groups of patients that don’t do well with what is considered the standard of care—and that many of them had postop problems with their biceps tendon. We secured a grant from Major League Baseball and investigated our way of repairing the labrum that involved sewing it down and taking the biceps tendon out of the shoulder joint. Interestingly, we learned that little if anything happened to the shoulder. We are overturning the traditional wisdom that all superior labral lesions needed to be fixed.”
Industry took note of Dr. Romeo’s unconventional methods, and extended its hand. “Right out of fellowship I was on the design team for a DePuy shoulder replacement system; I went on to work on a shoulder replacement system with Tornier. I developed their first press fit stem, and I was the first surgeon in the United States to implant their shoulder in 1997. Now, I design and develop shoulder replacement systems and techniques, including advanced arthroscopic techniques, with Arthrex. We are changing the instrumentation such that shoulder replacement can be done minimally invasively, without injuring the rotator cuff. This is going to change rehabilitation and will be easier on the tissues around the shoulder…it also may improve the longevity of shoulder replacements.”
Now a far cry from the soda shop in Idaho, Dr. Romeo muses about his journey, “Growing up in a small town in Idaho didn’t exactly lend me confidence that I could compete on a bigger stage. I have been pleasantly surprised that I could succeed against some of the brightest people I have ever met. One of my greatest assets has been my determination. Whenever someone threw up a roadblock, I just went over or around it. When I made it known that I was going to begin focusing my practice solely on shoulder and elbow, my partners had a meeting to discuss how this was going to affect our practice since this was less than half of my patients at the time. I pursued my plan and within six months my practice was twice as busy. Another thing that drives me is that I find tremendous personal value in helping others, something which makes me ‘dig’ until I find the answer to their problem. It’s very rewarding to hear, ‘If anyone can figure it out, it’s Dr. Romeo.’”
Dr. Romeo has brought his sense of purpose and big heart to his most important ‘operation’—raising his five daughters. “On the weekend, usually Sunday lunch, we gather around and talk for a couple of hours about what is going on in their lives. We also take trips together, attend various sporting and cultural events, and periodically head to the mountains for snowboarding or to the beach to relax. As for my personal time, I get up each day at 4:00AM to work out—whether I feel like it or not. In the overall scheme of things it’s what keeps me healthy so I that can enjoy life to its fullest. It also gives me the ability to manage and overcome stress and life’s challenges.”
Dr. Anthony Romeo…extending and building the quality of life.
are there any videos of rotator cuff replacement?