Meet our Docs: Greg Rennirt, M.D., says keeping patients active is the essence of sports medicine
By Kristy Bleizeffer Nov 5, 2018
If Greg Rennirt, M.D., could leave patients with just one message, it would be this: Once you stop moving, it is hard to start again. Don’t allow pain to get in the way of the activities you love to do.
“You don’t have to give up doing anything at 55, 60 or even 65. There is no reason to let age stop you,” said Dr. Rennirt of Advantage Orthopedics and Neurosurgery in Casper. “I would love it if 70-year-olds were all out running marathons.”
Dr. Rennirt is a board-certified orthopedic surgeon with a fellowship in sports medicine from the Lipscomb Clinic in Nashville, Tenn. He brings more than 25 years of experience to Casper.
Orthopedics used to be about reacting to pain or injury. A patient tore a rotator cuff, for example, and an orthopedic surgeon fixed it. Now, they try to prevent the tear in the first place.
“Especially in sports medicine, we are trying to step in earlier and make people healthier. We are probably the only occupation around that is constantly trying to put ourselves out of business,” he said. “I really like to encourage people to be more active, and I like to work on problems before they become surgical.”
In this “Meet our Docs” interview, Dr. Rennirt talks about the role of patient goals in sports medicine and the orthopedic advancements that have him the most excited.
Where did you grow up, and when did you become interested in medicine?
I grew up in Kentucky, and as long as I can remember I have wanted to be a doctor. I don’t really know what triggered it. Probably the earliest experience that imprinted itself on me was meeting Harold Kleinert, a world-famous hand surgeon. Some people say he started the practice of hand surgery.
How did you meet him?
I was 9 years old. My uncle was babysitting me and cut his thumb very badly. This was before we had cell phones, so he could not get in touch with my parents. I went to the hospital, and my uncle was back in surgery, and I sat out in the waiting room by myself. It was late at night, and Harold Kleinert came out and said, “Who is with Mr. So and So?”
“I am,” I said.
He looked at me, saw that I was all alone, and he said, “Are you hungry?”
He took me and got me something to eat and drink and I thought, “I want to be just like this guy.”
So you didn’t know he was famous at that point?
No. I had no idea who he was; I was 9. It just made such an impression on me that I actually went to medical school to be a hand surgeon. I didn’t realize how famous he was until I got to medical school. If you Google his name, you will see he started hand surgery back in the ‘50s and ‘60s.
I know he has no idea how he touched me, but I will never forget that.
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Did you get a chance to meet him?
Oh, yeah. I trained with him. The University of Louisville in Kentucky has a world-famous hand center where surgeons will do 20-hour hand surgeries.
Did you tell Dr. Kleinert about the time you met him?
Yeah. He didn’t remember it of course and his quote was, “That doesn’t sound anything like me.”
I said, “Well, maybe being 9, I saw the good in everything.”
He said, “I just can’t imagine me being that nice to you.” He was kidding, of course.
What do you think you found so impressive about the encounter? Him being nice to you, or that he fixed your uncle’s thumb?
I think it was both. He just seemed larger than life. He put my uncle’s thumb back on and to a 9-year-old, he was this huge person. I have never really wanted to do anything else. I don’t know if that is what triggered it, but that is my earliest memory of medicine.
I always wanted to be a hand surgeon when I was younger. Of course you don’t know anything about hand surgery until you get there, but I knew I wanted to fix people. The great thing about orthopedics is you take someone who is healthy, they get hurt and then you fix them. That is what I was interested in.
What led you to sports medicine?
In residency, you get exposure to all the different fields of orthopedics. When I started medical school in 1988, arthroscopy was first becoming available. To go from making big incisions to fix a bone or joint, to doing the exact same surgery through incisions a fourth of an inch long, was intriguing. And, it was challenging. The first couple of times I did it, I said, “I want to do this the rest of my life.”
I also really enjoyed working with people who are still working and are active. I like the challenge of taking someone who is functioning at a very high level and getting them back to that high level. Not just making them feel better, not just making them so that they can tolerate the pain, but getting them back to where they were before. That is the essence of sports medicine.
Tell us about your experience as a team physician.
In fellowship, I worked with the NFL’s Tennessee Titans. That was their first year moving up from Houston, so I was in Nashville at the time. I also worked with a lot of the semi-pro teams.
After I finished the fellowship and returned to Louisville, I was the primary team doctor for our arena football team, the Louisville Fire. I was also on staff with the Florida Panthers, a National Hockey League team, and their AHL team in Louisville. So I had all the pro teams in Louisville, except the semi-pro baseball team. I did that for a few years. I loved it.
Then I worked with some of the college athletes and high school athletes and did that for probably five to seven years. Then my son started to get a little older, and I couldn’t be on the road as much. I transitioned to a private practice, taking care of high school athletes but not traveling all the time.
How do you see that experience working into your practice here in Casper and Wyoming?
Again, it all gets back to looking at someone’s pre-injury level of activity and setting that as your goal post-op. The same rules apply to everyone: If I am seeing an NHL player who needs shoulder surgery, but wants to get through the season, we work for that goal. If a construction worker comes in saying he needs to work until November, it is really the same principle.
What advancements in orthopedics have you excited?
The great thing about sports medicine is that things change almost every day. I routinely see patients who have had a surgery on one shoulder and they will have the same problem on the other shoulder. They’ll say something like, “Do it just the way you did before.” I’ll explain that we don’t do it that way anymore, and they’ll say, “Well that was only two years ago!”
Things change so fast in orthopedics. The newest hot field in sports medicine is biologics – harnessing your body’s own healing potential. Treatments like harvesting stem cells and platelet-rich plasma (PRP), concentrating it and then putting it where it needs to be. Over the next 5 to 10 years, that is definitely the future of sports medicine.
Right now, it is not really available to the average person because of the cost. Insurance doesn’t cover it and these modalities can cost $350 to $3,000 and most people just don’t have that kind of money lying around. And, there are still treatments that insurance will cover.
So classic examples are the gel injections in your knee. Those generally cost $700 to $1,000, but insurance covers them. Many studies show that the PRP (platelet-rich plasma) works just the same and is half the cost, but insurance doesn’t cover PRP. So, to a patient, they can get the gel for free versus having to pay $350 to $500 for the PRP. I think at some point insurance companies are going to switch over and, believe it or not, a lot of times these things are cheaper than what they are covering.
What’s changed in joint replacement over the last 20 years?
Traditionally, patients were told that they didn’t want a total hip or total knee replacement until they were retired or until they were no longer active. The last generation of implants would wear out. On the newer implants, we are not seeing the wear that we used to see.
Yes, it is still a concern. You don’t want to do a total knee on a 50-year-old unless it is a last resort. But, you also don’t want to tell that 50-year-old to suck it up until they’re 60. You don’t want to give up your 50s because you are worried about what will happen in your 70s. In fact, I believe the fastest-growing age group for total knees is the 50- to 55-year-olds.
What kind of activity level can people expect after a joint replacement?
Most people can get back to a fairly normal life. We don’t put the restrictions on them that we used to. A standard total hip, a standard total knee, a standard total shoulder, within reason, we get you back to lifting weights or back to playing sports. Most people, if you tell them they can’t play sports or can’t go to the gym, then they say they don’t need the knee replacement.
I have treated a lot of body builders – very, very heavy-weight lifters – who want to continue to power lift. I push them away from total shoulder replacement. Instead, we look at other procedures that can help get them through the next 2 to 5 years so they can continue their sport. But, if someone is willing to say, “Look, I am 60 years old, power lifting is done, but I still want to go to the gym and I still want to stay active, then absolutely they are a candidate for a total joint replacement.
So these decisions are really patient driven.
Absolutely. It is not my job to tell someone what they get. My job is to be a resource for the patients. I need to make sure they understand all the pros and cons of everything we have to offer and, within reason, it is always their choice.
Patients are going to live with the decision we make for the rest of their lives. My job is to lay all the options out for them, tell them what I think after 25 years of experience and thousands of patients, and help them make the call. I always tell them that they are the ones who are going to live with this.
When do you recommend patients come see an orthopedic surgeon?
I always encourage people, to see their doctor if they have lasting pain. If pain is stopping you from being more active, then it is a serious problem. Even minor pain, if it is changing your activity in a way that affects your health, it needs to be treated.
A 55-year-old who is experiencing knee pain may not feel like seeing a doctor because they figure there is nothing they can do. They chalk it up to getting older and quit running. Don’t do that.
I would always recommend getting in sooner if you are not able to do the activities you want to do.
What do you think of Casper so far?
We have been coming to Wyoming for more than 20 years and we love it. My wife and I always thought we would retire here. But I hadn’t had any interaction with the medical community here.
Since I accepted the job back in June or July, I have been really impressed with the quality of doctors you have here. I know a lot of people, when they think of Wyoming, they say you are going to the middle of nowhere. That is not how it is. You have world-class doctors here, and the hospital is amazing.
I love Casper. The friendliest people you will ever meet. We never thought we would find a community in Wyoming where we could come and work and be busy. I never dreamed that there would be a trauma center in the middle of Casper with a draw area of a quarter-million people. You have world-class facilities, you have great doctors, and I have just been really impressed.
Dr. Greg Rennirt is a board-certified orthopedic surgeon with a fellowship in sports medicine from the Lipscomb Clinic in Nashville, Tenn. He has more than 25 years experience in orthopedic surgery. After completing his sports medicine fellowship, Dr. Rennirt returned home to Louisville, Ky., and joined a group of six orthopedic surgeons. He was lead physician for an American Hockey League team and an arena football team, and he was on the medical staff of the Florida Panthers NHL team. He has served as medical director for the KentuckyOne Health neuro and ortho service lines, covering 105 area hospitals.