Joseph Zuckerman, MD
NYU Hospital for Joint Diseases
When I was approached by Exactech in 2003 to get involved in the development of the Equinoxe® shoulder arthroplasty system, little did I know that 10 years later I would be part of the fastest-growing system in the United States.
During my first 20 years in practice, I declined many opportunities to be involved in implant design. I didn’t feel it was the right time in my career, and I was also concerned about avoiding conflicts of interest. When I was first approached by an Exactech representative, who I had known since I began practicing medicine in 1984, my decision to meet with Exactech was based on my long-standing relationship with him.
I knew of Exactech founders Bill Petty, MD and Gary Miller, PhD from their days at the University of Florida. It also was my interactions with Exactech product development experts that convinced me to move to the next stage of participating on the Equinoxe design team: meeting my potential collaborators Tom Wright, MD, and Pierre-Henri Flurin, MD.
Tom and Henri were fundamental to my participation on the Equinoxe design team. Tom is a skilled clinician and a very smart person, but most importantly he is a “regular guy,” who is easy to work with, easy to talk to and easy to collaborate with. Henri is an outstanding shoulder arthroplasty surgeon and collaborator who brought tremendous knowledge and experience to the team. Everyone on our design team is comfortable with each other, we like one another and we look forward to our meetings.
Tom and Henri were fundamental to my participation on the Equinoxe design team.
With the close working relationship we developed, we built on Henri’s replicator plate design to bring a complete shoulder arthroplasty system to market. It was—and still is—the only system retroversion, neck angle, medial and posterior offset of the humeral head.
Over the years, we have worked together to create the first platform stem that allows surgeons to convert an aTSA to a rTSA without stem removal, and we developed a philosophy to conserve glenoid bone with augments and cage designs. Our goal was to minimize complications, such as scapular notching, that we had seen with other implant designs.
“The rest is history,” as they say. Since 2003 we have added new members to our design team, our engineering team and our product development team. Strong collaboration is also an important part of our clinical evaluators program. The meetings we have with our clinical evaluators embody the basic approach we have followed since the beginning: we recognize the importance of relationships and we work hard to support them in any way we can.
To be successful in orthopaedics, of course we had to develop a superior and innovative product. But the single, most-important factor driving our success with the Equinoxe shoulder system is the relationships that developed from that first day more than 10 years ago. •
“In 2003, I was approached by Phil Matinale, who was working for Exactech. I had known Phil since I started in practice in 1984. Phil and I developed a very nice relationship that has continued through the years.”-Joseph Zuckerman, MD
“Although I wasn’t quite convinced Darin Johnson [pictured fourth from the left] really played baseball at a Division I school (if you consider Ivy League baseball Division I), I liked what Darin had to say and what I learned about Exactech.”—Joseph Zuckerman, MD
“Without exception, each person we’ve added to the team has fit in very well and developed relationships that are productive, constructive and meaningful. This is nothing less than the foundational elements of the success of the Equinoxe.”—Joseph Zuckerman, MD
From didactic lectures to cadaver courses to surgeon-to-surgeon training, the design surgeons’ participation in medical education is critical to helping surgeons improve their outcomes.