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Dr. Tashin Ergin of Essex Orthopaedics & Optima Sports Medicine in Salem marks a patient's shoulder before a procedure. (COURTESY)

Salem surgeon uses TunnelPro System for less invasive rotator cuff surgery

Robert Degregorio recently bought a new house and proceeded to paint all the ceilings and doors himself. No small accomplishment for anyone, but for Degregorio, who had been in pain for years, this household endeavor represented a new life - free of the pain he had before rotator cuff surgery just over a year ago.

Less than two months ago, Robert Brown also experienced long-desired pain relief. He had suffered a ruptured bicep in his right arm that led to the discovery of tears in the rotator cuff along with arthritis in the shoulder area.

The pain relief came just in time as he is going to be a grandfather of twins come November. "I told him he had to fix my arm so that I can pick up those babies," said Brown.

The "he" referred to by Brown is Dr. Tahsin Ergin of Essex Orthopaedics & Optima Sports Medicine in Salem, who performed both Degregorio's and Brown's surgeries utilizing a method performed by very few surgeons that is minimally invasive and entirely arthroscopic.

How it works

As Ergin explains, the ArthroTunneler TunnelPro System, the first device of its kind, provides the ability to arthroscopically drill small bone tunnels for suturing the tendon to bone. This better preserves the bone as anchors. Utilizing just suture material, this procedure works by creating only tiny tunnels into the bone, enhancing healing.

"By utilizing this method, you lose less bone," said Ergin. "Not only is this good for obvious reasons initially, if revision is necessary in the future it will be a better situation as the bone hasn't been damaged."

The tunnel method is technically difficult to do, and there is a definite learning curve attached to it, he said, which is why he believes a lot of surgeons do not utilize it. He said he uses it in almost every case, however, estimating that he has employed the procedure 150 or more times at this point.

The surgery may at times take a little longer than if a traditional method is used, but by and large his patients have been enthusiastic about the results and appreciate how non-invasive it is, allowing for a smooth recovery.

Informed patients

According to Brown, 67, having his surgery done in this fashion meant that all most people saw at the beach were "five little x's around my shoulder that they thought were birthmarks." He said going into the surgery, he had a firm understanding of the benefits of the process and the procedure itself. "They explained things so thoroughly, I didn't have any questions," said Brown.

Actually, Brown did have questions, but not for Ergin. His questions were for the three other doctors he saw over the course of a year who failed to diagnose him. According to Brown, Ergin, on his very first visit to him, asked him to raise his arms and flex them.

He immediately, before even conducting an MRI, informed Brown that he had a ruptured bicep in his right arm. Once the cuff tear was confirmed, he then recommended the entirely arthroscopic surgery utilizing no anchors. "I wish I had found Essex Orthopaedics sooner. It would have saved me a lot of time, pain, money and surgery," said Brown, who has had 12 surgeries, most of them orthopaedic.

Degregorio, 68, also felt educated about his choices and the procedure, and was pleased to have selected the fully arthroscopic method. He said he felt very little pain after the operation, which he attributed not only to the procedure and Ergin's expertise, but also the fact that he followed through with all the instructions he was given for after care, including use of ice, medications and physical therapy.

Injuries are part of aging

Ergin explained that the method he utilizes is different from other techniques and positions patients well should there be a need for revision surgery in the future. And for many people, rotator cuff surgery will be necessary.

According to Ergin, on average, more than 50 percent of people over the age of 65 will have a rotator cuff problem. Increase the age to over 80, and he said nearly 80 percent will suffer from rotator cuff injuries. "For many, it's simply a part of aging, extensive use and wear and tear over the years," Ergin said.

"I played a lot of sports - football, hockey, baseball and softball - and eventually it takes a toll on your body," said Degregorio.

Brown believes his injury simply came from use, and potentially a wrong turn while lifting light weight at a gym where he worked out. "It doesn't take much for you to get hurt," he said.

While recognizing he still has months of recovery ahead, Brown said he is looking forward to joining another gym and to swimming, a passion of his that he could not participate in due to the pain in his arm.

"It's kind of hard to swim with one arm. I was swimming in the pool in a circle like a wounded fish," joked Brown.

Both Brown and Degregorio found Ergin through prior experience with Essex Orthopaedics & Optima Sports Medicine. Degregorio had been the director of athletics at Merrimack College and the school contracted with the company as the teams' doctors. "They did a great job taking care of our athletes and coaches," he said. So it was only natural when he himself needed care to seek out their services.

Brown had earlier had a total knee placement done by Dr. Thomas Hoerner of Essex Orthopaedics & Optima Sports Medicine, and pleased with the results, sought out his recommendation when it came time for his arm surgery.

Hoerner encouraged him to talk to Ergin, and in doing so, it was determined that he would be a candidate for the all-arthroscopic surgery. From there, he said it was an easy decision.

Ergin stressed that the method using the ArthroTunneler TunnelPro System is not appropriate for all rotator cuff injuries, however.

He explained that there are four parts to the rotator cuff, and whether or not this type of surgery should be used depends on what part is injured. It also depends on what type of tear and placement as well.

Brown was glad to have been a candidate for the minimally invasive surgery.

"I'm not 100 percent yet, but I'm well on my way," said Brown, adding that it's important for people to know that they don't have to travel far to find top-notch doctors who are at the forefront of state-of-the-art care and using the least invasive techniques.

And while he is hoping that his surgery days are over, he describes himself as an "Essex Orthopaedics customer for life."Degregorio had his surgery in July 2013 and began months of physical therapy in August.

When he went to see Ergin in February, he was told he could begin to lightly swing his golf clubs. "In March, he said 'swing away,' and I haven't looked back since," said Degregorio.

Essex Orthopaedics & Optima Sports Medicine in Salem specializes in sports medicine, minimally invasive and arthroscopic surgery for shoulder, elbow, wrist, hip, knee, foot and ankle and has a physical therapy team that works with pre- and post-surgical patients, sports injuries and performance enhancements.

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