Two recent events have reinforced the importance of teamwork for me in sports medicine.

The first occurred while I was performing an arthroscopic shoulder rotator cuff repair on a 62-year-old woman and was the largest rotator cuff tear I had ever repaired. At one point during the surgery, I commented that I wished I had a camera to take a picture of the entire operating room and all of the staff that was doing their job at that very second. Without them, there was absolutely no way that I could even come close to repairing such a large rotator cuff tear or doing any surgery for that matter.

The nurse anesthetist was monitoring the vital signs and keeping the blood pressure within a range that did not allow for excessive bleeding but on the other hand was not so low that it would harm the patient. This requires constant monitoring, concentration and attention by the anesthesiologist and nurse anesthetist. Without them, I can't perform the surgery.

Then there is a circulating nurse in the room who is not sterilely scrubbed in to the case. The circulating nurse is constantly being asked for supplies, instruments and implants. She is also constantly monitoring a pump that pumps fluid through the shoulder in 3-liter bag increments. During the course of the four-hour surgery, she replaced 69, 3-liter bags of fluid, never once allowing the saline to run out, which would disrupt my ability to do the case. She also was constantly monitoring other pieces of equipment.

There was scrub tech who was handing me all the instruments I needed in addition to holding the arm in different positions for me, holding the arthroscope at times and assisting me at every step.

Another scrub tech scrubbed in to help me out for an “extra set of hands” because the surgery became very complicated. At one point, there were 22 suture ends that were free within the shoulder and coming out of various portal sites/poke holes that needed to be kept track of and that I needed to avoid tangling up. At one point, the anesthesiologist stated it looked like a “cat's cradle.” With the two scrub tech's help, I was able to keep track of all those sutures and not allow any of them to become tangled up amongst themselves or within the soft tissues of the shoulder.

There was also an equipment rep in the room who helped us with varying tips and pointers on how to use the most “state of the art” equipment that is currently available for repairing rotator cuff tears arthroscopically. Without those people, there would have been no way that I could repair that rotator cuff.

We were able to perform that surgery through several small poke holes. In the past, it would have been done with a large open incision and may or may not have even been able to be repaired due to the large size of the tear. There is still no guarantee that the patient will do well. She has many months of rehabilitation but that brings up a whole other team who will help the patient recover, and without them my surgery is all for naught.

The bottom line is that I realized, and hopefully patients realize, that it is not just the surgeon or the doctor that you go to who is responsible for how well you do. I have a tremendous office staff and support staff that works to support everything I do. They certainly deserve a tremendous amount of credit, and it is no different than any other team sport - without all the team members, including the support staff, the team cannot win.

Later that same evening, my office volunteered its time and services for the Auburn Indians Pop Warner free physicals for the football players and cheerleaders. This organization is the only organization in the area still offering these physicals free of charge.

The physicals were held July 19 and 26, and there were 25 people who donated time and effort so that 140 athletes were able to receive free physicals. Many of these volunteers are extremely busy physicians, who donated one or both nights towards this service. Dr. Charles Keenan, Dr. Richard Nangle, Dr. Cassandra Archer, Dr. Mark McSwain, Dr. Karin Kroeger, Dr. David Dinello and Dr. Michael Glowacki all volunteered. Our physician assistant, Michelle Fassinger, and our nurse practitioner, Stephen Berwind, also donated their time, and we had outstanding support staff help from John Henry, Denise Hooper, Jennifer Swartwood, Lori Delgado, Annette Feeney, Tracy Klock, Dale Buchberger, Ann Hagen, Derek McKenzie, Karen Zamniak, Kim Bohall and Tony Tabone.

I wanted to personally thank all of them, but I also think that if you see them in the community, please give them a thank you yourself.

Dr. Marc P. Pietropaoli is a board certified/fellowship trained

orthopedic surgeon/sports medicine specialist and is president of Victory Sports Medicine & Orthopedics in Skaneateles.