"I wanted it to be a 'global' replacement system so that anybody on the globe could receive it," said Dr. Rockwood. This desire, coupled with his knowledge of the shoulder, one of the most complex joints in the human body, has resulted in the Global prosthesis becoming the most used shoulder replacement system in the world.
Usually shoulder replacement candidates suffer from either a fracture or a form of arthritis, which can cause extreme pain and stiffness and diminish a patient's range of motion. "What people really want," said Dr. Rockwood, "is relief from pain. With the Global prosthesis they will gain more motion than they had before the surgery. The shoulder never returns to 'normal,' but the patients end up with a functional shoulder and pain relief."
The GlobalTM Total Shoulder Prosthesis System includes three components. Two of them, a metal ball that replaces the head of the humerus (bone which extends from the shoulder to the elbow) and a body with stem that is secured into the upper arm bone, are available in multiple sizes. The third component is the glenoid (shoulder blade socket) prosthesis which replaces the socket part of the joint. Depending upon the severity of the problem, a patient may require all three parts of the system, a surgical procedure termed total shoulder arthroplasty, or two parts of the system (metal ball and stem units), a procedure called a hemi-arthroplasty.
Dr. Rockwood developed the system at the request of DePuy Inc. of Indiana. "I agreed to develop it provided there would be superb teaching manuals, materials, videotapes, etc., for the product, so the doctor could go home and explain to the patient what is to be done," said Dr. Rockwood. "And for the first five years of its availability there was a proviso that the prosthesis would not be sold to a doctor until he or she took a course on how to use it. The most important part of the Global system is teaching the surgeons how to use it."
While the proviso has expired, surgeons from around the world continue to attend Dr. Rockwood's classes in shoulder replacement system techniques. Participants review videotapes demonstrating surgical techniques and then observe Dr. Rockwood perform shoulder replacement surgery via closed- circuit television. "I have a microphone and they have microphones, so it becomes interactive," explained Dr. Rockwood. Michael A. Wirth, MD, associate professor of orthopaedics and shoulder surgeon, moderates the closed-circuit surgical procedure. He fields questions from the attendees, and he and Dr. Rockwood comment extensively on the hows, whys and wheres of the procedure.
The class also includes a skills lab during which doctors implant the shoulder replacement system in synthetic plastic shoulder bones. At the end of the course participants leave with teaching manuals, videotapes and plastic models of the prosthesis and bones. The models help patients understand what the surgeon will be doing at the time of the procedure.
Most patients require a three-day hospital stay for a total shoulder replacement. "Our patients come in on a Monday and leave by Wednesday," said Dr. Rockwood. "They also start an exercise program the same day as the surgery."
There's yet another part of Dr. Rockwood's shoulder system—a rehabilitation kit that includes all of the necessary materials for rehabilitation of their shoulders. Patients take the kit home following surgery. "I have found it more convenient for the patients to be able to do their rehabilitation at home. The kit includes a fully illustrated booklet of all the exercises to be performed and a videotape demonstrating how to do them. This way the patients can do the rehab at their leisure, three to four times per day at home, seven days per week—they can even do their rehabilitation exercises in their offices or while on vacation. If patients follow the recommended exercise regimen, most of them can begin to hit golf balls around eight weeks following surgery. They're playing real golf after 12 weeks."
Dr. Rockwood has devoted the past 30 years of service to the Health Science Center. He was the third faculty member to be hired in the Medical School. He served as the first chairman of orthopaedics and continued in that position until 1988 when he stepped down to devote more time to research and writing. He continues full time in the department, and his practice is limited to the care of shoulder problems.
A native of Oklahoma City, he earned degrees from Oklahoma City University (OCU) and the University of Oklahoma (OU) and graduated from OU's School of Medicine in 1956. In 1961 he completed his orthopaedic residency at the OU Medical Center. Dr. Rockwood received an Honorary Doctorate of Humanities from OU in 1993 and was inducted into the Oklahoma Hall of Fame in 1996. In December he will receive an Honorary Doctor of Sciences degree from OCU.